Applications for your providers may only be obtained through your organization. Please provide this application to your provider(s) and have them return it to your organization. If your provider refers to a specialist physician in a private practice setting, please determine if that physician requests participation in this program. If so, please forward an application to that physician and list his/her name and specialty above.
If you have any questions, please call the Office of Primary Care at (405) 271-8427.
Please forward the completed Provider Application to