Skip to main content Skip to footer
 
 

Add New Facility Form

Please complete this form to add a provider to your existing contract with Baylor Scott & White Health Plan (BSWHP).

Submission of this form is not an automatic approval to BSWHP's network. We will contact you for more information or confirmation of your request.

Please complete all fields. Enter N/A if a field is not applicable.

* Indicates required information

Scroll To Top