HEALTHLINK | PROVIDERS >> PROVIDER COMMUNICATIONS

Electronic Provider Communications Request Form

***NEW*** Receive Important HealthLink Provider Communications Electronically.

All providers - even if you have completed a similar request previously, please complete and submit the Provider Communications Request Form to ensure timely updates are received.

We appreciate your continued partnership with HealthLink.

Provider Communications Request Form

HealthLink wants to help declutter your offices by sending certain provider communications such as bulletins, newsletters, training invitations, policy change notifications and authorization updates through email.

Requestor Information *

* First Name

* Last Name

* Email

* Title

* Address

* City

* State

* Zip-Code

* Phone Number (XXX-XXX-XXXX)

* Provider/Group/Facility Name

* Tax ID number

* NPI number