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Individual application — Allied health care professional
Information entered into the PDF application cannot be saved. You must print, sign, and return (by email, fax or mail) the completed application to TMIC. Applications will be processed within 5 to 7 business days.
 

Individual application — Dentist

HIPAA-HITECH Business Associate Agreement

An agreement required by federal law concerning necessary policies and procedures to assure the confidentiality of patient health information.