Profile EAP Monthly Webinar Series
Tool-building webinars for your well-being. To attend a seminar or webinar view the schedule.
Becoming a Provider
If you are interested in becoming a provider, contact our Network Coordinator to request provider forms.
Complete the forms and submit with the following paperwork listed below. All paperwork must be completed and returned to our network coordinator.
- Provider Application, signed Statement of Understanding and W-9.
- Two Affiliate Agreements signed. (One will be returned to you).
- Copy of State license(s) with expiration date clearly visible on the copy.
- Proof of Professional Malpractice Insurance with dates of expiration.
- Resume including education, post-graduate training, and professional experience.