New Providers Application Process for CHOICE, SSBG and Title 3 Programs
- Complete new provider application packet and return as indicated on the packet checklist.
- New providers must currently be serving at least one client under another funding source to be considered for application.
- The establishment of a contractual agreement provides no guarantee of referrals for service delivery.
- Request for a complete application packet, including the contract, and any questions can be directed to:
Beth Krudop, VP of Administration
8101 W. Jefferson Blvd.
Fort Wayne, IN 46804
Or via email at email@example.com