Application - Step 1 of 4

Thank you for your interest in applying with Perimeter Anesthesia.   

Please download the form below to a computer with Microsoft Word, type into the form, and upload in the form box.  There is no need to sign the credentialing form.  It will be sent back to you to sign electronically via Docusign.

Once you have uploaded the completed GA Uniform Credentialing Form, please click at the bottom of the page to continue to page 2.