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Add My Doctor

I would like to continue visiting my current doctor.  However, my doctor is not yet listed as a member of Group Health Network.  Please add my doctor so I can enjoy all of my membership benefits without having to change doctors.

Group Health Network will contact your doctor, using the contact information you provide us in the form below.  Although it is not required, it may be helpful if you personally mention Group Health Network to your doctor before we make contact.

Following is my doctor's contact information (please complete a seperate form for each doctor):

    Contact Information

    Please include your doctor's complete street address. Include more than one street address, if you visit your doctor at more than one office location.
    Feel free to include any additional contact information or comments.
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