Dental Provider Quarterly Report

Quarterly Reports are to be completed within 60 days following the last day of each quarter.

How to Submit Dental Provider Quarterly Reports

There are now 2 ways to submit your quarterly report to TCWD:

  1. Online Submission: Please click here to access the online quarterly report. An automatic email will be sent to your practice site contact for confirmation of employment (administrator/manager will not need to sign form). 

  2. Download Form: Please download this form and submit via email to TCWD@tha.com. Please note site administrator/manager signature is required on the downloaded form. Completed forms may be submitted via email TCWD@THA.com, faxed to 615.242.4803, or mailed to the address below:

  Tennessee Center for Health Workforce Development
  5201 Virginia Way
  Brentwood, TN 37027