Agency Qualified Providers
Existing Qualified Providers Requesting to Add/Delete Services
Submit the following documents via email to firstname.lastname@example.org
|1||Application to Amend Services|
If the services you are applying to provide moves up to a higher service category (see: Provider Minimum Qualifications), submit Executive Director’s resume.
Note: Agencies who DDS determines to meet minimum qualifications for the additional services will be asked to submit the additional required policies, if applicable, and any revisions to existing policies that may apply. All required policies must be accepted and on file. Each policy must be submitted as a separate document.
Select hyperlinks in the Policy Requirements Based on Support Level for the policy templates.
Note: For other supports, see detailed service definitions on the Waiver Services page.