Treatment Providers Application Details

Important information to ensure that the professional fees charged are fair.

It is an absolute condition of your professional recognition by WPA that you will provide your patients with written details of your fees in advance of treatment taking place.

In the event that a patient is not reasonably advised of fees (in writing), and there is a shortfall they have not agreed to, WPA reserves our rights to support the patient in resisting demands for any additional payment. In addition, WPA reserves the right to withdraw recognition from any provider in these circumstances.

Please Note: WPA will only register one address against your record. Please ensure that the address provided on this form is the one where all correspondence and payments must go. In the event that a customer of ours is due to pay the balance of any bills to you, they will be provided with this address to facilitate this. Also details of your provider entry may appear on our website.


Option 1: Complete your application

If we have sent you a letter with your temporary provider number please complete the fields below:



   




Option 2: Start an application

Please select from the drop down menu below the relevant application form:




Completing this application should take no more than 5 minutes.

The following page will ask for:

arrowDetails of yourself
arrowDetails of your position and qualifications
arrowPayment details

Please make sure you have this information available before continuing.