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Preferred Provider Application Form

If you wish to make a change to a provider from your practice or register as a new practice then please complete the form.

Click here for a guide on how to complete this form.

Please contact if you experience any issues completing the form or you have other enquiries.

By completing this form, you agree to the TUH Terms and Conditions and declaration in Section 2 linked below.

To view the Terms and Conditions please;

  • Click here if you are part of the TUH preferred provider network
  • Click here for general information for providers (fund rules etc.)

If you'd like to view how we collect and store your information you can view our privacy policy here.















I acknowledge that:
a) I have received, read and agree to comply with the Terms and Conditions governing the TUH Preferred
Provider Network. I acknowledge that these Terms and Conditions will apply to the practice and its
providers from the date on which TUH accepts this application;
b) I understand that by submitting this application form to TUH I am applying for the practice and its providers
to join the TUH Preferred Provider network;
c) I understand that TUH may accept or reject this application at its sole and absolute discretion;
d) I understand that I (or another authorised representative of the practice) may withdraw this application at
any time before TUH notifies me that it has made a decision about whether to accept or reject it;
e) All the information I have provided to TUH with or in connection with this application form is true and


Join our network.