Providers

BECOME A PROVIDER

• Resume requirements for DMHA wraparound services program provider manual.
• Child and Adolescent Needs and Strengths training and certification:
  For information about the CANS training and registration, click here. You can also receive additional information by contacting our CANS trainer. The CANS certification is required for wraparound facilitator applicants.
• Wraparound Practitioner Certification program: Required for all wraparound facilitation service providers. Additional information regarding enrollment in the certification program will be provided to eligible applicants at time of provider approval. Completion of the certification program will be required for continued approval of the provider as a wraparound facilitator.
• Child Mental Health Wraparound orientation for wraparound facilitators: Participants in this webinar will have access to a certificate at its completion which can be submitted with an application. Click here to view the presentation.

Provider Approval Forms

• Application cover sheet
• Facility-based respite application form
• Inkless registration instructions
• Provider agreement
• Provider demographic application
• Rendering services provider application for individuals requesting authorization as a provider of wraparound facilitation, habilitation, respite and/or training and support for the unpaid caregiver services
• Resource guide for CMHW HAB, FST and RES providers
• Resource guide for CMHW wraparound facilitators
• Tobi user agreement for wraparound facilitators