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SIGNING UP

At BPUC, we make signing up easy!

To start services in your community,  you will first need to schedule a consultation.  You can do this by filling out the information on our "Contact Us" page or by simply calling  us at  (828)855.1192.  


Once the consultation is completed, we request the following: 


For the facility:

  • Tax ID
  • NPI (if applicable)
  • Address and phone number


For the resident:

  • Consent to Treat Form
  • Release of Information Form
  • Current FL2
  • Insurance Information
  • Resident Registry
  • POA. Information (if applicable)


We understand how valuable your time is, so we want to make the registration process as easy as possible.  If you  would like a member of our staff to personally assist you in this process, please  "Contact Us"  through this website or  simply give us a call at  (828)855.1192.   We look forward to working with you! 


Please Download and complete the following forms

Once you have completed the forms for each patient, please fax them to (828) 358-0832.   

New Customer Set-up (pdf)

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Consent to Treat - (pdf)

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Release Authorization - (pdf)

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