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Credentialing Request Form

Credentialing Request Form

Use a credentialing request form 0 template to make your document workflow more streamlined.

Section IV. Required - Select from Dropdown List DOB* Social Security Number* Gender* State License #* License Expiration Date* UPIN* NPI Number* Practitioner Email Address** *Required for practitioners new to DaVita. **If different from email address in Section I. DEA #* Male Female Click here to visit and view facilities in your area! III. Practice Information Practice Name Street Address City Phone State Fax Zip IV. Facility Requests (Add or Remove Facilities from the...
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What makes the davita request form legally valid?

As the world takes a step away from in-office work, the completion of paperwork increasingly happens online. The davita credentialing form isn’t an any different. Dealing with it utilizing electronic tools is different from doing this in the physical world.

An eDocument can be considered legally binding given that specific needs are satisfied. They are especially crucial when it comes to signatures and stipulations related to them. Typing in your initials or full name alone will not ensure that the organization requesting the form or a court would consider it executed. You need a reliable tool, like signNow that provides a signer with a electronic certificate. In addition to that, signNow keeps compliance with ESIGN, UETA, and eIDAS - major legal frameworks for eSignatures.

How to protect your davita credentialing signnow when filling out it online?

Compliance with eSignature laws is only a portion of what signNow can offer to make form execution legitimate and safe. Furthermore, it offers a lot of opportunities for smooth completion security wise. Let's quickly go through them so that you can stay certain that your davita credentialing request remains protected as you fill it out.

  • SOC 2 Type II and PCI DSS certification: legal frameworks that are set to protect online user data and payment details.
  • FERPA, CCPA, HIPAA, and GDPR: key privacy standards in the USA and Europe.
  • Two-factor authentication: adds an extra layer of security and validates other parties' identities via additional means, such as an SMS or phone call.
  • Audit Trail: serves to catch and record identity authentication, time and date stamp, and IP.
  • 256-bit encryption: sends the information securely to the servers.

Filling out the davita credentialing template with signNow will give better confidence that the output form will be legally binding and safeguarded.

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