The Texas Standardized Credentialing Application (TSCA)  is a state mandated application that adopts a standardized form for verification of physician credentials.  Use of the application form by hospitals, HMOs and PPO's is a state requirement for credentialing of practitioners.

Save the TSCA on your personal computer for future use in applying for initial credentialing and recredentialing at hospitals, HMO's, and PPO's.  You may complete the form by computer or on paper and print or photocopy it for each hospital, HMO or PPO.   Practitioners may keep the information current on the TSCA by revising and saving the data on their own personal computers.  

To download the TSCA for your use, please click the link below.

Texas Standardized Credentialing Application

All UTSW affiliated hospitals share a campus wide addendum to the application.  Addendum to the Texas Standardized Credentialing Application (TSCA) includes information required by the institutions and regulatory agency requirements.  Please print the Addendum and photocopy it for each UTSW affiliated hospital in which the applicant is applying for privileges, and submit with your TSCA.  Please do not save the addendum to be submitted at a later date as this document is revised often. To ensure you have the most recent version please refer to the link below for most current version.

To download the Addendum for your use, please click the link below.

*PLEASE NOTE: The following form is a PDF document that requires Acrobat Reader to open. In order to view this document you will need to download Acrobat Reader. Click here to download this free software.

Addendum

Each University affiliated hospital requires documentation of 48 hours of continuing education every two years for MD/DO's, and 24 hours every two years for DDS's.  All UTSW affiliated hospitals share a campus wide continuing education attestation.  Please print the Continuing Education Attestation and photocopy it for each UTSW affiliated hospital in which the applicant is applying for privileges, and submit with your initial or re-credentialing packet. 
 
Please note that a random 5% audit will be performed on annual basis by each UTSW affiliated hospitals.  Any practitioner who is randomly selected as part of the 5% audit will be notified in writing and will be required to provide appropriate documentation within a reasonable amount of time for each institution.

To download continuing education attestation for your use, please click the link below.

*PLEASE NOTE: The following form is a PDF document that requires Acrobat Reader to open. In order to view this document you will need to download Acrobat Reader. Click here to download this free software

CME Attestation