1st Medical Network

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Home > For Members > Nominate a Provider

Provider Nomination Process:

If you have a provider that you would like to see added to 1st Medical Network, please follow the link to print an application request form.

  • Please print the Provider Application Request Form and share it with your provider.

  • If your physician is interested in joining the network, he/she must complete the information and return the form to 1st Medical Network via fax.

  • Please note that completion of this form will not result in automatic inclusion in the network.

  • The provider must meet certain criteria and agree to accept our fee schedule before he or she is eligible for the recruitment process review.

  • The provider must also be credentialed by the network before he or she can see 1st MN members.

  • Note: The credentialing process takes approximately 60-90 days to complete from receipt of a completed application (including all requested documents).



Nominate a Provider


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