Demographic Update Forms
ATTENTION: If you are currently a provider participating in one or more Health Net of California networks and are having issues registering for the new provider portal, DO NOT submit the network participation forms below.
Instead, please send an email with your contact information so a provider network representative can reach out and assist.
Health Net is committed to providing our providers with the best tools possible to support their administrative needs. We have created an easy way for you to request updates to your information and ensure we receive what we need to complete your request in a timely manner.