Provider and Healing Priory Sign Up

Provider and Healing Priory Sign Up

In order to sign up as a provider within our network or sign up your facility, please fill out the application below.

To complete the online forms, you'll need your driver's license, a photo headshot and resume, licenses and/or certifications. IT IS HIGHLY RECOMMENDED TO HAVE THESE ITEMS READY BEFORE BEGINNING THIS APPLICATION.

*Money will be refunded if not approved, w/ exception of $30.00 background check. (Note: Not all fees will be returned)

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