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Medical Staff Application

Applying for Privileges

To apply for privileges at Calvert Memorial Hospital, please complete the following steps.

  1. Download and complete the Maryland State Credentials form
  2. Download and complete the CMH Supplemental Application form. 
  3. Fill out the Delineation of Privileges form request. The appropriate form for your specialty will be e-mailed to you within two business days.
  4. Once completed, mail all three forms to the mailing address below.  
Calvert Memorial Hospital
ATTN: Medical Staff Services
100 Hospital Road
Prince Frederick, MD 20678

If you have any questions, please contact us at or 410-535-8242

Special Privilege Requests

- Moderate Sedation Packet and Test
- Fluoroscopy Packet and Test

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