Sentara Hospitals Medical Staff Application Request Form

The Sentara Hospitals Credentialing Office processes applications for Medical Staff membership and clinical privileges for physicians and allied health professionals for the Sentara hospitals listed below. To request an application, please complete the Sentara Hospitals Medical Staff Application Request Form by clicking on the link below and answering all of the questions. Your application will be sent to the email provided within 3 to 5 business days. We will contact you if we have any questions.

  • Sentara Albemarle Medical Center
  • Sentara CarePlex Hospital
  • Sentara Halifax Regional Hospital
  • Norfolk Hospitals
    • Sentara Norfolk General Hospital
    • Sentara Leigh Hospital
  • Sentara Northern Virginia Medical Center
  • Sentara Obici Hospital
  • Sentara Princess Anne Hospital
  • Sentara Virginia Beach General Hospital
  • Sentara Williamsburg Regional Medical Center

Request an application form by emailing A link to the application will be sent to the email address you provided within 2 to 3 business days.

For additional information or questions about this form, please contact us at:

Sentara Hospitals Credentialing Office
600 Gresham Drive, 7B
Norfolk, VA 23507
Phone: 757-388-6175757-388-6175
Fax: 757-388-6176

Application Request for Sentara Martha Jefferson Hospital:

Pat B. Robertson, CPCS, CPMSM
Manager, Medical Staff Services
Sentara Martha Jefferson Hospital
500 Martha Jefferson Drive
Charlottesville VA 22911
Phone: 434-654-7309434-654-7309
Fax: 434-654-4419


Application Request for Sentara RMH Hospital:

Sentara RMH Medical Center
Medical Staff Services Department
2010 Health Campus Drive
Harrisonburg VA 22801
Phone: 540-689-1551540-689-1551
Fax: 540-689-1541