Before you complete this form:
  • If you are joining a non-PHS group practice, please check with them to see if they are planning to pay some or all of your fees.
  • Please verify with the Credentialing office (505-923-5993) exactly which fees you need to pay.
  • Please complete the following questions with the name and contact info of the person submitting the payment.

Please Note: Providers being hired by Presbyterian may skip this payment system. Presbyterian Medical Group will be invoiced for your application fees.

The following fields should be completed by the person making the payment, and the information you provide should match the information in the credit card account.