Please select the application for Oklahoma below.

Oklahoma Physician Application

Please print and fill out the form. The PDF file is large if you would like to
download it now and fill it out later please right click the form and select
"save object as"

Once filled out please contact us at through the phone numbers below.
We will help you with any questions you may have about filling out the
form and sending it to ESS.

Phone: (866)931-8882
In Dallas: (972)934-3200

To view PDF files, you will need Adobe Reader, installed.
Download it for free here .