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CompHealth Locum Tenens Application
Downloadable Forms
The CompHealth application procedure involves the initial application, a skills checklist and other credentialing materials.
If you have questions or need more information, you can contact a representative at any time by calling 866.630.5886.
Two easy ways to apply for a Locum Tenens assignment with CompHealth:
Option 1: Complete the application online, print it out, initial and sign in the required places and mail or fax it to the number at the top of the application.
You do not have to complete the online application in one sitting. You may stop at any time and continue later by logging in and resuming where you left off.
In addition, you will need to print, complete and send in the Background Check Authorization form (described below).
Option 2: Download the application (pdf), print it out, complete, initial and sign in the required places and mail or fax to CompHealth.
Fax: 866.724.7059 (toll-free)
or
Attn: Anesthesiology
CompHealth
PO Box 713100
Salt Lake City, Utah 84171-3100
Adobe Acrobat Reader required.
In addition, you will need to print, complete and send in the following forms:
Anesthesiology Skills Form (pdf)
Supplemental Claim Form (pdf) Complete a form for each malpractice claim you've experienced. Include/attach all third-party documentation for any malpractice claims (complaint/answer/judgment).
Background Check Authorization (pdf) Authorizes a criminal background check to be processed.
