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.
- 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)