Behavioral Health Provider Network Participation Form

Please Note: This form is only for use by Behavioral Health Providers requesting to participate in the Seton Employee Plan (SmartHealth).

  • PLEASE NOTE: The Seton Employee Plan (SmartHealth) is only available in the following counties: Bastrop, Bell, Bosque, Burnet, Coryell, Falls, Hamilton, Hays, Hill, Limestone, McClennan, Travis, and Williamson.
  • Accepted file types: jpg, gif, png, pdf, doc, docx.
  • This field is for validation purposes and should be left unchanged.