---
title: Telehealth Provider Credentialing Form Template | Paperform
description: Complete credentialing form for telehealth platforms with multi-state license verification, telemedicine training, insurance capture, technology assessment, and provider availability scheduling.
url: "https://paperform.co/templates/telehealth-provider-credentialing-form"
type: static
generatedAt: "2026-03-28T00:45:22.358Z"
---

[← Back to free form templates](/templates/)    ![Telehealth Provider Credentialing Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/telehealth-provider-credentialing-form.png)
    [Preview](https://_preview.paperform.co/ai-template/telehealth-provider-credentialing-form) [Use this template for free](/create?ai-template=telehealth-provider-credentialing-form)    [Human Resources Forms](/templates/category/hr/)[Healthcare & Medical Forms](/templates/category/healthcare/) [Staffing & Recruitment](/templates/industry/staffing-recruitment/)[Healthcare](/templates/industry/healthcare/)[Telehealth](/templates/industry/telehealth/)[Human Resources](/templates/industry/human-resources/) [HR Manager](/templates/role/hr-manager/)[Recruiter](/templates/role/recruiter/)[Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Therapist](/templates/role/therapist/)[Healthcare Administrator](/templates/role/healthcare-admin/)     About this free form template
### Streamline Your Telehealth Provider Onboarding with Paperform

As telehealth continues to expand across state lines and become a cornerstone of modern healthcare delivery, credentialing providers efficiently and securely has never been more important. This **Telehealth Provider Credentialing Form** is designed specifically for telehealth platforms, digital health companies, and medical groups that need to onboard clinicians quickly while maintaining rigorous compliance standards.

#### Why This Template Works for Telehealth Platforms

Credentialing is often a bottleneck in healthcare recruitment—particularly for telehealth, where providers may hold licenses in multiple states, work across time zones, and need to meet specific technology and training requirements. This template consolidates everything into a single, professional form that collects multi-state license information, verifies telemedicine training completion, captures malpractice insurance details, assesses technology readiness, and schedules provider availability—all in one streamlined experience.

By using Paperform, you can customize this template to match your brand, add conditional logic to show only relevant questions (for example, different license fields based on states served), and integrate directly with your credentialing database, HR systems, or communication tools. The result is faster onboarding, fewer back-and-forth emails, and a better first impression for new providers joining your network.

#### Automate What Comes Next with Stepper

Once a provider submits their credentialing form, the real work begins: verifying licenses, requesting additional documents, scheduling orientation, and adding providers to your roster. With [Stepper](https://stepper.io), Paperform's AI-native workflow automation platform, you can automatically route submissions for internal review, send verification requests to state medical boards or third-party services, trigger background checks, and notify your compliance team—all without manual handoffs. Stepper keeps your credentialing pipeline moving and ensures nothing falls through the cracks as your provider network scales.

#### Who This Template Is For

This form is ideal for telehealth platforms, virtual care providers, healthcare staffing agencies, hospital systems expanding into telemedicine, mental health platforms, and any organization that needs to credential remote clinicians across multiple jurisdictions. Whether you're onboarding physicians, nurse practitioners, therapists, or other licensed providers, this template gives you a professional, compliant starting point that's ready to customize and deploy.

Get started with Paperform today and turn credentialing from a paperwork nightmare into a seamless, automated experience that supports your mission to deliver accessible, high-quality care.
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