For Providers /

Provider Application

If you share our mission of caring for children with special needs, we want YOU on our team!

Our families are served by healthcare professionals statewide.  We continually strive to partner with healthcare professionals who care for children with special needs.

It’s easy to apply.  You can complete the on-line application or contact us for assistance.  We will need the following information:

  • Training & experience information (DSCC form and CV)
  • Tax information (DSCC form or W-9)
  • Insurance information for health care professionals (DSCC form and liability certificate)

We look forward to answering your questions and assisting you with the application process.