If you are a Texas physician requesting coverage, please go to our TMLT website at http:\\www.tmlt.org.
If you are a physician working outside of Texas, please go to the Lonestar Alliance website at http:\\www.lonestara.com.
Individual application — Allied Health Care Professional
Please complete this online application for coverage. Once the application is submitted, the document will be sent to our team to start the review. We will be in touch with any questions.
Telemedicine Questionnaire
If you practice involves telemedicine, please submit this questionnaire with your application.
Chiropractic Questionnaire
If you are a chiropractor, please submit this questionnaire with your application.
Nurse Midwife Questionnaire
If you are a nurse midwife, please submit this questionnaire with your application.
Podiatry Questionnaire
If you are a podiatrist, please submit this questionnaire with your application.
HIPAA-HITECH Business Associate Agreement
An agreement required by federal law concerning necessary policies and procedures to assure the confidentiality of patient health information.