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Please print out this page or document the required information
below.
To join the UBH Network, please complete the following:
Click here to
go to the U.S. Map page, select your state, and print out
the documents as noted:
- UBH State Clinician Contract (please complete and
sign the last page)
- Clinicians in PA and VA, please also complete
the UBH Supplemental Attestation Form
Mail all of the above
documents to:
United Behavioral Health
Attn: Florence Martin
4170 Ashford Dunwoody Road, Suite 100
Atlanta, GA 30319
(Please be sure to keep copies for your own records.)
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