Notification of Change of Ownership (CHOW)

  • Please use Google Chrome to complete this form.

    A Notification of Change of Ownership form (CHOW) is required when participating healthcare providers are involved in a practice transfer to a new owner. The CHOW collects detailed information from both the Purchaser and Seller. Neighborhood Health Plan of Rhode Island will review the CHOW information prior to the processing of any contractual changes.

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  • Purchaser must submit a CHOW. Click here and save this form to your desktop, complete the CHOW (with signatures from Purchaser and Seller), and attach/upload the document to this form.
  • Accepted file types: doc, docx, xls, xlsx, pdf, Max. file size: 10 MB.