Provider Profile Services Form

Please use the form below to submit provider specialties and related services to the Sanford Health Plan Referral Center. Information entered will identify the specific facility where your services are provided. **DO NOT use this form to refer a patient or provide any patient information here.**

Contact the Referral Center at healthplanreferralcenter@sanfordhealth.org or call (844) 836-1616 or (605) 333-1616 with questions or profile changes.

Specialty & Services Information

Please add all specialties and related services