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Provider Registration- New Provider Packets

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Presentation on theme: "Provider Registration- New Provider Packets"— Presentation transcript:

1 Provider Registration- New Provider Packets

2 On Login Page, Select Provider Registration

3 Select Provider Type - either Employee, Independent Contractor, Agency or Participant

4 Input Providers Demographic Information including name, address, DOB, phone number and SSN. Then Click Next

5 Click Next Select which services the provider will be using. Then Click Next

6 Select and Print the Documents You Want – Required Forms must be printed in order to proceed

7 Once the Forms are Downloaded, Click Submit
Please Note: Submit button will not work until you print the forms.

8 The Demographic Information Previously Entered Will Auto Populate in all Downloaded Forms

9 Registration Complete!

10


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