Important Application Information
Please read carefully before proceeding
This form is a request to begin the TIOPA membership application process. Upon submission, our credentialing team will email you secure login credentials and a link to complete your full application. You are responsible for submitting your complete application within the required timeframe. If you do not receive your application access within three (3) business days, please contact credentialing@tiopa.org.
Response Time
Within 3 business days
PAYMENT REQUIRED
To begin processing, please pay the appropriate application fee below. Applications will not be reviewed until we receive payment.
• Standard Physician fee applies to MD, DO, DPM, OD, DC.
• Standard Allied Health fee applies to PA, DPT/PT, OT, LPC, LSW, MFT, PhD, RD, SLP.
• Standard APRN/CRNA fee applies to APRN/CRNA.
Application Form
Complete all required fields accurately
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You’ll receive your secure login credentials within 3 business days.