north carolina INFANT-TODDLER PROGRAM
(NC ITP)

provider agreement

The N.C. ITP Provider Agreement is a legally binding document that establishes the relationship between the N.C. ITP/Children's Development Services Agency (CDSA) and a service provider. The Provider Agreement is required to enable a provider to serve families with infants and toddlers through the N.C. ITP and requires providers to implement services as written in the individualized Family Service Plan (IFSP). Providers who sign this document must comply with the N.C. ITP policies and procedures and provide services that meet both federal regulations and state requirements.

Photo of a family

Potential Service Provider Survey-Application (PDF)

N.C. ITP Provider Agreement (PDF)

Attachment 1 to Provider Agreement (PDF)

NC ITP Requirement for Service Provider Agency Employees / Subcontractors (PDF)

Service Provider Plan Agreement Amendment (PDF)

Service Provider Roster (PDF)

Change Request Form (PDF)

ITP Confidentiality Agreement (PDF)

Verification of Acceptable Criminal Record Check (PDF)

N.C. ITP Provider Agreement FAQ (PDF)

North Carolina Infant-Toddler Program |919-707-5520

I feel like in our situation we were in dire need of help. I just love that there is a program out there that said, I care about your child.
-- parent of a child served by the Sandhills CDSA

I’m learning as much as my daughter is. We’re all learning and that’s a big deal. It’s not just for her; it’s a whole family thing.
-- parent of a child served by the Greenville CDSA

When I first got into the program my goal was to have support and understanding because this was new. To get a diagnosis of your child having Down Syndrome, the first thing that comes in your mind is fear; fear not only for the present but for the future. Until I was in contact with the CDSA I didn’t know what to do.
-- parent of a child served by the Cape Fear CDSA (Fayetteville area)

Updated: Jul 15, 2020