Becoming a Provider
If you are interested in becoming a provider, contact our Network Coordinator to request provider forms.
Complete the forms and submit with the following paperwork listed below. All paperwork must be completed and returned to our network coordinator.
- Provider Application, signed Statement of Understanding and W-9.
- Two Affiliate Agreements signed. (One will be returned to you).
- Copy of State license(s) with expiration date clearly visible on the copy.
- Proof of Professional Malpractice Insurance with dates of expiration.
- Resume including education, post-graduate training, and professional experience.
Welcome to Profile EAP
Profile EAP is a full service Employee Assistance Program headquartered in Colorado Springs, Colorado. Started in 1982 by Penrose-St. Francis Health Services and now part of Total Healthcare - backed by the staff, facilities and resources of Centura Health, Profile EAP provides services to both the employee and the employer.
Our experienced staff is trained to assist you and your employees in all areas of employee assistance; from counseling to substance abuse; management consultations to trainings and leadership development to trauma debriefings.