Hospital Affiliations form

---
title: Hospital Affiliations form
description: Access, review and validate the Hospital Affiliation details of a healthcare professional in the Hospital Affiliations form.
locale: en-US
canonical_url: https://www.servicenow.com/docs/r/employee-service-management/hr-service-delivery-for-healthcare/hr-hos-aff.html
release: brazil
product: HR Service Delivery for Healthcare
classification: hr-service-delivery-for-healthcare
topic_type: reference
last_updated: "2026-09-10"
reading_time_minutes: 3
breadcrumb: [HR Service Delivery for Healthcare reference, HR Service Delivery for Healthcare, HR Service Delivery, Employee Service Management]
---

# Hospital Affiliations form

Access, review and validate the Hospital Affiliation details of a healthcare professional in the Hospital Affiliations form.

<table id="table_l3d_s5j_jbc"><thead><tr><th>

Field

</th><th>

Description

</th></tr></thead><tbody><tr><td>

Healthcare professional profile

</td><td>

Profile of the healthcare professional.

</td></tr><tr><td>

Name

</td><td>

Name of the affiliated hospital at which the healthcare professional works.

</td></tr><tr><td>

Privilege start date

</td><td>

Date starting which the healthcare professional has the required permissions to work at a hospital affiliation.**Note:** This field appears only when **Temporary** is selected in the **Privilege type** field.

</td></tr><tr><td>

Privilege end date

</td><td>

Date until which the healthcare professional has the required permissions to work at a hospital affiliation.**Note:** This field appears only when **Temporary** is selected in the **Privilege type** field.

</td></tr><tr><td>

Privilege type

</td><td>

Level of privilege the heathcare professional has at the affiliated hospital: Temporary or Fully unrestricted

</td></tr><tr><td>

Type of admitting privilege

</td><td>

Nature of admitting privilege, for example, can the healthcare professional only admit a patient at an affiliated hospital, or admit, treat and perform surgeries at an affiliated hospital.

</td></tr><tr><td>

Percentage of admissions

</td><td>

Percentage of admissions that the healthcare professional accepts at an hospital affiliation.

</td></tr><tr><td>

Active

</td><td>

Option to indicate that the Hospital Affiliations record is active and available to use.

</td></tr><tr><td>

Is primary

</td><td>

Option to indicate that it is the primary hospital that the healthcare professional is affiliated to.

</td></tr><tr><td>

Status

</td><td>

Status of the hospital affiliations record: -   New: When profile intake form is sent to the healthcare professional for filling.
-   Pending validation: When data is filled in by healthcare professional and sent for credentialing and validation to HR agents.
-   Invalid: When HR agents review the profile data and reject due to insufficient date or invalid details.
-   Valid: When HR agents validate and approve the information provided by the healthcare professional.

</td></tr><tr><td>

Address

</td><td>

Address of the affiliated hospital at which the healthcare professional works.

</td></tr><tr><td>

City

</td><td>

City in which affiliated hospital is located.

</td></tr><tr><td>

State/Province

</td><td>

State in which affiliated hospital is located.

</td></tr><tr><td>

Zip

</td><td>

Postal code of area in which affiliated hospital is located.

</td></tr><tr><td>

Country

</td><td>

Country in which affiliated hospital is located.

</td></tr></tbody>
</table>**Parent Topic:**[HR Service Delivery for Healthcare reference](https://raw.githubusercontent.com/ServiceNow/ServiceNowDocs/brazil/markdown/employee-service-management/hr-service-delivery-for-healthcare/reference-hr-healthcare.md)

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