| Document | Description |
|---|---|
| Steps to Becoming a Consultant | Tells you everything you need to know to become a consultant for CDC+. |
| Provider Enrollment Cover Sheet (Checklist) |
This form is the cover sheet for the package you must complete to become authorized by Medicaid to provide consultant services and to be added to the CDC+ Consultant Registry so you can be selected by CDC+ participants to be their consultant. |
| File Maintenance Form - Blank | |
| Consultant Memorandum of Agreement | The Memorandum of Agreement is a written agreement between the APD area office and each consultant or consultant agency. The agreement sets forth the responsibilities of the consultant or consultant agency for the CDC+ Program. |
| Consultant Registration Form - Solo Practitioner | Use this registration form if you are a solo practitioner. If you work for an agency and are the only WSC with that agency who is also a consultant, you must register as a solo practitioner. When a second WSC completes consultant training and registers as a consultant, you complete a Consultant Registration Update form and change from solo to agency-affiliated. |
| Consultant Registration Form - Agency Affiliated | Use this registration form if you work for an agency. |
| Agency Registration | Each agency with 2 or more WSCs who are registered as CDC+ consultants must register as an agency for consultant services. |
| Consultant Registration Update Form | Use this form to change any information on your original registration form. |
| Agency Registration Update Form | Use this form to change any information on the original registration form |
| CDC+ Participant Review Form | Complete this form each month to document your required monthly contacts with your CDC+ Participants or their Representatives. |