Join Our Network

If you are interested in becoming a Cynergy Care network provider all you need to do are the following:  

  • Agree to accept and treat patients that are referred to you by Cynergy Care.
  • Provide the treatments within your area of specialization that are included in the various benefit programs managed by Cynergy Care.
  • Execute the provider agreement and complete the provider application form.
  • Provide care and services in a manner that is consistent with internationally recognized standards as well as the level of quality in your local health or dental care community.

 You can complete the application online. Once we receive your completed application and executed agreement, Cynergy Care will evaluate your application according to its quality credentialing guidelines.

Please contact Cynergy Care for more information about how to join the Cynergy Care Network.

APPLICATION FORM FOR HOSPITAL / CLINIC TO ADHERE TO CYNERGY CARE NETWORK

REMINDER: The indication of your account details is not a collection authorisation and has the sole purpose to accelerate the payments to your practice of services rendered under this agreement.

Morning Afternoon
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
  • Yes No
  • Yes No
  • Yes No
  • On-site parking Extended hours Child friendly Credit card accepted Disabled access
  • English
  • Credit card Cheque Cash

All fields must be completed

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