INTERESTED IN BECOMING A MEDWAIVER PROVIDER?
CHECK THE REQUIREMENTS TO SEE IF YOU QUALIFY
THE FOLLOWING LIST OF ITEMS ARE REQUIRED FOR ALL APPLICANTS. THIS IS A PARTIAL LIST.
ALL PACKAGES INCLUDE COMPLETE CHECKLISTS.
Level II Background Screening
Two Employer Reference forms or two letters of recommendation
Proof of minimum educational qualification(s) for applicant
• A high school diploma, GED certificate, or college transcripts must be submitted.
4. Copy of Professional licenses or Certifications
5. Copy of driver's license, vehicle registration, and insurance
6. Proof of Identification
7. Social Security Card
8. State Business Registration