An official website of the United States government
Here's how you know
A .mil website belongs to an official U.S. Department of Defense organization in the United States.
A lock (lock ) or https:// means you’ve safely connected to the .mil website. Share sensitive information only on official, secure websites.

 

 

 

DHA Centralized Credentials Verifications Office Support Service

Priorities:

  • Standardizes and consolidates Primary Source Verification activities;
  • Ensures military treatment facilities receive properly completed Primary Source Verification credentials packages; and
  • Coordinates Recruiting Service Accession and the MTF credentialing and privileging process.

Mission: Support the Air Force Medical Service through dependable and objective review, Primary Source Verification and the documentation of credentials.

Required Air Force Credentialing and Privileging Forms

To access Master Privileging Lists, AF Instructions and Forms, Welcome Letters and more, please click here.

Form Completion Tips

(Currently AF Form 1540)

Time gaps of 30 days or more between periods of training, education, or employment must be explained in the "Remarks" section. A statement must be made to document the activities and location of the provider during the period, to include vacation, relocation activities, etc.

Applicants currently in training programs are required to supply updated DHA Form 367 and Clinical Privilege Lists no more than 45 days prior to completion of a training program.

Contact Us