Thank you for your interest in joining the network of Participating Providers with the Bureau of Family Health.
To enter into a PPA, you must (1) complete the agreement, several appendices and attachments, (2) sign the agreement and (3) return it to the Bureau.
All necessary information and forms are available online. All documents can be downloaded as either Adobe Acrobat or Microsoft Word files and printed.
Overview for Completing and Submitting the PPA
Step 1: Download and print all required forms.
Step 2: Type or print all information so that it is legible. If you choose to complete the information by hand, you must
use a non-erasable, blue or black point pen. Do not use pencil.
Step 3: Attach all required supporting documentation.
Step 4: Keep a copy of your completed PPA package for your records.
Step 5: Send the completed PPA package with original signatures and all required documentation to the address
indicated. Do not fold the PPA package - especially the signature page.
Providers are responsible for submitting a COMPLETE and ACCURATE agreement. Please comply with all the directions on the instructions page, including the submission of the mandatory appendices and attachments. Incomplete or inaccurate PPAs cannot be processed.
Providers who submit an incomplete PPA will receive a letter requesting the missing items required to complete processing. If a provider does not respond timely to this request for additional information, the agreement will be rejected and returned. To reapply, the provider will need to start the process over and complete an entirely new PPA.
Please select from the list below, the Provider Type that most closely describes the services(s) that you provide. Each link listed below contains all forms needed to complete the process.