Already in our network?

Keep our members up-to-date.

As a current Trust provider, keeping your listing current and accurate is vital for Trust members to locate you.
Notify us when a change in your organization, practice, contacts, location, or practitioners takes place.

Organization Provider Update (pdf)

For organizations with 4 or less service locations and 20 or fewer practitioners.

Use this form to report any changes to your organization's information including:

• Organization or business name
• Tax ID
• Address or location
• Billing information
• Contact information
• Phone/fax numbers

Individual Provider Update (pdf)

For individual practioners.

Use one form for each practitioner to report changes in:

• Practitioner specialties
• Practitioner service locations
• Practitioner effective or term dates
• Practitioner name or contact information

Send update forms Attention: Provider Services Manager, via fax 608.276.9119 or mail to WEA Trust, P.O. Box 7338, Madison, WI 53707-7338.