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Frequently accessed forms

FREQUENTLY ACCESSED FORMS

Clinician Tax ID – Add/Update Paper FormClick Here
Clinician Tax ID – Add/Update - TennCare Medicaid Network onlyClick Here
Optum Psych Testing Form
(For KanCare, Medica and Unison Psych Forms, Click Here)
Click Here
Wellness Assessment Form (Adult, English)
Click Here
Individual Provider Disclosure of Ownership FormClick Here
Clinician Specialty Attestation FormClick Here
Agency Specialty Attestation FormClick Here

For all forms covering administrative, clinical and claims needs, please click here.