By entering your details and clicking the 'continue' button you are agreeing to keep the information contained in the following pages strictly confidential and not disclose the details to any third party except by prior written consent of AXA Health* or where the Confidential Information has become publicly available through no fault of your own. You may only disclose the Confidential Information to your personnel who are directly involved in the administration of the fees and who need to know the information and You shall ensure that such personnel are aware of and shall comply with the confidentiality requirements in this Agreement.

*AXA Health is a trading name of AXA PPP healthcare Limited, a company registered in England and Wales under company number 03148119.

(Your Provider number is made up from your initials followed by five numbers. It can be found in the reference of any recent communications from AXA Health)

Please read the following documents. By clicking the "Submit" button below you are confirming you have read and accepted the Specialist Agreement, published fees, and terms of recognition.

Specialist Agreement

Published fees (this includes consultation fees)

Terms of recognition for specialists