Contacting the Affiliate Network Department

Network Manager
800-361-5527x122
Network@WellnessCorp.com

Please Complete the following forms.
Print them and Fax them
to Network Manager at 508-842-3066.

Credentialing Process

Application - New Individual and Agency - Reference Form

Re-Credentialing Application - Individual and Agency

Professional Reference Form

W-9 Form

Attention All Affiliates

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