Below are links to our most frequently accessed forms
FREQUENTLY ACCESSED FORMS | |
---|---|
Clinician Tax ID – Add/Update Online Form | Click Here |
Clinician Tax ID – Add/Update Paper Form | Click Here |
Clinician Tax ID – Add/Update - TennCare Medicaid Network only | Click Here |
Optum Psych Testing Form (For KanCare, Medica and Unison Psych Forms, Click Here) | Click Here |
Wellness Assessment Form (Adult, English) | Click Here |
Individual Provider Disclosure of Ownership Form | Click Here |
Clinician Specialty Attestation Form | Click Here |
Agency Specialty Attestation Form | Click Here |
For all forms covering administrative, clinical and claims needs, please click here.