EHN Application

If you are interested in joining our network, please fill out the application form below, or complete the linked PDF version and submit it to Once your application is submitted, you will be contacted to discuss the next steps.

If you have questions about the application paperwork or are a current provider in the network and want to update your demographic information, please contact If you have questions about joining our network or contracting with us and our associated health plans, please contact us at toll-free: 833-718-1220 number. We will be happy to connect with you.