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Provider Enrollment Forms

All forms needed for the following First Steps provider types are provided below:

For Specialists including: ABA Consultant, Assistive Technology Provider, Audiologist, Counselor, Dietician, Interpreter, Nurse (RN and LPN), Occupational Therapist, Optometrist, Ophthalmologist, Orientation and Mobility Specialist, Physical Therapist, Physician, Psychologist, Special Instructor, Speech/Language Pathologist, Social Worker, Translator, and Transportation Provider – Click here for enrollment forms.

For Providers Requiring Supervision including: ABA Implementer, Occupational Therapy Assistant (COTA), Paraprofessional, Physical Therapist Assistant (PTA), and Speech/Language Pathology Assistant (SLPA) – Click here for enrollment forms.

For Parents/Family Members: Click here for enrollment forms.  

For Service Coordinators: Click here for enrollment forms.