Forms for Contracted Services Partners
- Billing Forms for In-Home, DME, HDM, PERS, and Transportation Providers
- Billing Forms for Chore Providers
- Manual Billing Procedure
- Blank Billing Forms – REBILL
Potential Contracted Services Providers
Please contact Jenna Blamer, Contracted Services Coordinator, at 231-733-3524, 231-739-5858, or toll-free, 1-800-442-0054, or email@example.com, for more information on becoming a contracted service provider.
Application Forms for Potential Evidence Based Training Partner
*Contract Application files may be large in size. Please allow a few minutes for file to completely download before navigating. More or less time may be required depending on connection speeds.
*Contract Application files are in PDF format. Please ensure that you have downloaded the latest version of a compatible PDF reader with flash player. A PDF reader without compatible flash player will prevent files from being properly displayed.
Contact for Evidence Based Training Partners: Karla Betten, Grant Services Manager
Phone: 231-733-3593, 231-739-5858 or Toll Free: 1-800-442-0054