Application to Become a Qualified Provider

The application form includes a list of all required information that you need to submit along with your completed application form. Throughout the application form are links to information with more detail that might be helpful.

Use the DDP New Provider Application if you are not currently a qualified provider under contract with the Department to provide DDP services.

Use the Current DDP Provider/Add Service Application if you are currently a qualified provider of DDP services and want to be authorized to offer additional services.