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- Click ‘Get Form’ to open the MEDCO-13 application in the editor.
- Begin with Section 1, where you will select your provider type. Ensure you check the appropriate box and complete any additional sections as required.
- Move to Section 2, filling in your general information. This includes your current BWC provider number, business name, tax identification number, and practice location details.
- In Section 3, provide individual provider information such as date of birth, education/training details, and any board specialties. Attach necessary documentation as specified.
- Proceed to Section 4 and answer all questions truthfully. If you answer 'yes' to any question, provide a detailed explanation on a separate sheet if needed.
- Finally, review Section 5 for the provider application agreement. Sign and date the application before submitting it through our platform.
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