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Texas Department of Insurance
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Credentialing Forms Listing

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TDI form number Description Format Language
LHL234 Application Package
PDF English
LHL234a Other Professional Degrees
Attachment A
PDF English
LHL234b Other Post-Graduate Education
Attachment B
PDF English
LHL234c Other Work History
Attachment C
PDF English
LHL234d Other Current Hospital Affiliations
Attachment D
PDF English
LHL234e Other Previous Hospital Affiliations
Attachment E
PDF English
LHL234f Other Practice Locations
Attachment F
PDF English
LHL234g Malpractice Claims History
Attachment G
PDF English

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