Professional Liability Application
On this website you will find the application for your professional malpractice coverage applicable when working for IASIS Healthcare. You will need to complete the application in its entirety, attach the required documents and e-sign it.
To complete this application, please use the hyperlink below to log-in, complete a new application or log-in to return to an application in process. When completing the application, use the 'next' or 'back' button in the applciation. Use of the web-browser navigations buttons is not recommended. Where the application indicates, please remember to include any required attachments in your submission. Attachments include, but are not limited to:
- Your CV
- Certificates of insurance (COIs)
- A certificate of foreign medical school graduate (if applicable)
- Any other items the application required should be attached to your application when you submit the completed form. An incomplete application may result in the application being returned to you.
If you have any questions regarding the questions on the application, please email firstname.lastname@example.org
Thank you for your submission.
Risk Management & Insurance
Doug Mitchell, MSN, BS, RN, BC, CPHQ, CPHRM
National Director, QI, Risk and Regulatory Compliance
IASIS Healthcare Provider Networks