BCS Client Providership Registration

Complete the appropriate form and fax all required documents outlined to BCS Credentialing Specialists at 866-808-3630

The PDF version has an option when you open the document to highlight or print on the upper right hand side; if you select the hightlight option you can fill in the blanks and then print it completed before faxing it to our office.

The online version is secure and safe and the easiest way to complete the form.

Please contact Lee Broadston with any questions regarding these forms.