Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Request Privileges

To request privileges at Methodist West Houston Hospital, please contact our Medical Staff Services office. Once a request is received, we will send you the following materials:

  • Texas Standardized Credentialing Application
    Note: This form will not be mailed to you but may be found at: http://www.tdi.state.tx.us/forms/lhlhmo/lhl234.pdf
  • Delineation of Privileges Form
  • Confidentiality and Security Agreement Form
  • Addendum to Texas Standardized Credentialing Application
  • Professional Liability Insurance Corporate Standards information
  • Pharmacy signature card
  • A Medicaid/Medicare form
  • A copy of the Medical Staff Bylaws and Rules and Regulations
  • Electronic Medical Records Acknowledgement/Attestation
  • Email Account Preference
  • Remote Access Request
  • ICARE Values Statement

Please note: This process can take 30-90 days depending on the complexity of the data and the number of data elements being verified and investigated.

If you have any questions regarding our credentialing process and timelines, please contact:

Lana Baker, Manager of Medical Staff Services
Email: labaker@houstonmethodist.org
Phone: 832-522-0320