Request to Join Our Network

Provider and Facility Form

Thank you for your interest in joining our Network!

Practitioners, please fill out the form below so that we may begin your credentialing process. If you are a Washington State provider, you must utilize the Onehealthport ProviderSource application. All providers must have either a CAQH or ProviderSource application to begin the credentialing process with First Choice Health.

Facilities, please fill out the form below and someone will reach out to you to let you know next steps.