Instructions for Membership Application
To begin the application process to join CCPA, please follow these steps:
- Thoroughly review the CCPA Bylaws, CCPA Physician Master Agreement and the CCPA Product Description. These documents outline the terms and conditions between CCPA and the physician, as well as for participation in CCPA's fee-for-service agreements.
- If you find the terms and conditions in the above documents agreeable, please use this Application Checklist to complete the CCPA Membership Application.
Please ensure that you complete ALL of the documents below:
3. If your practice is new to CCPA, please also complete the following documents:
4. Submit your completed application materials to CCPA:
Mailing address: 225 E. Chicago Avenue, Box 113, Chicago, IL 60611
Questions about the CCPA membership application?
Please contact LaVonna Swilley at 312.227.7425 or firstname.lastname@example.org.