IMPORTANT: Postal service strike will impact mail delivery. Access your benefits online. Visit our guide for help.

Winter break: Our offices are closed December 25, 2024 - January 1, 2025. Regular hours resume January 2, 2025. Our member site and app are available 24/7.

Close
Skip to main content

Providers

Health services provider

Request for changes to secure website access

Provider information

Please enter your existing information

Please enter the provider name
Please enter your Login ID
Please enter a valid address.
Please enter a valid city.
Please enter a valid Postal Code.
Please enter a valid email address.
Please enter a valid phone number.
Please enter a valid fax number.

Requested changes

* Please indicate the changes you’re requesting below and provide any mandatory information required for the changes you’ve selected in the sections that follow










Practitioner 2

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 3

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 4

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 5

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 6

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 7

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 8

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 9

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number

Practitioner 10

Please enter the practitioners name
Please enter the college or association name
Please enter the registration number
Add Practitioner