Below you will need to upload the following documents:
- Your IRS CP575 letter which shows the legal entity name and Tax ID*
- A voided check of your clinic's business account.* MUST have the business name and address printed on the check! This is needed because most insurance companies require an electronic payment method to pay you for your services to patients.
*If you do not have these documents you will need to wait to complete this form until you have obtained these documents.