Request an Application

Thank you for your interest in joining our network of high-quality integrative healthcare providers.

Prospective providers can use this form to request a credentialing application. Once you’ve completed and submitted this request form, you will receive an email with additional instructions within two business days.

You’ll be able to submit your application through CHP’s streamlined portal process, with the ability to import CAQH® application data through the “Claim Your Profile” process within the CredentialStream® software.

If you have questions about CHP or the application process, please contact us.