Menu   WellSpan Health
Banner _Crowd Scene

WellSpan Employee Assistance Program

WellSpan Employee Assistance Program

Provider Forms & Information

Participating Provider Forms

Participating Provider Step-by-Step Procedures (explains referral WSEAP process) 

WSEAP Statement of Understanding form (this must be signed by every EAP patient)

Sample EAP HCFA 1500 Claim Form (please use this as a guide for all claims)

WSEAP Referral & Invoice Form (use only if provider cannot use HCFA 1500 form)

New Provider Application

Client Status Report (completed by therapist after any supervisor referral session)

Adobe Acrobat Reader is needed to view these documents. Click here if you need to download a reeder.Adobe Acrobat Reader is needed to view these documents. Click here to download.

Are you sure you would like to cancel?

All information will be lost.

Yes No ×

About the provider search

This search will provide you with WellSpan Medical Group and Northern Lancaster County (Ephrata) Medical Group primary care physicians and specialists. If we don’t have a WellSpan Medical Group physician to meet your criteria, the search will expand to include community physicians who partner with WellSpan Medical Group physicians through the WellSpan Provider Network or provide care to patients on the Medical Staffs of WellSpan’s Hospitals.

×

Schedule Your Next Appointment Online with MyWellSpan

Use your MyWellSpan patient portal any time to view available appointments, and pick the date and time that best suits your schedule.

Go to MyWellSpan

New to this practice?

If you don't have a WellSpan primary care provider and would like to schedule a new patient appointment with a provider who is accepting patients, just log into your MyWellSpan account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to see the offices that are accepting new patients in relation to your zip code. If you are not enrolled in MyWellSpan, go to www.mywellspan.org, call 1-866-638-1842 or speak with a member of the staff at a participating facility to sign up. New patient scheduling not available at all practices/programs.

Already a patient at this practice?

If you already have a relationship with a WellSpan practice, simply log into your account, and go to the Appointment Center section. As you progress through the scheduling process, you will be able to schedule an appointment with any provider or practice that already counts you as a patient. Online scheduling varies by practice/program.

×