Apd application: Fill out & sign online

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Click ‘Get Form’ to open the APD Provider Enrollment Application in the editor.
Begin with SECTION A, where all providers must list the counties they intend to serve. Fill in your contact information, including name, telephone number, and email address.
Indicate whether you are a SOLO or AGENCY provider and provide your business name along with your FEIN or SSN.
In SECTION B, if you are a new provider or expanding services, list your educational qualifications and attach necessary documents like diplomas or transcripts.
Detail any current or past services provided to APD customers, including service types and dates.
Complete the certification sections at the end of both sections by printing your name, signing, and dating the application.

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Can I fill out and sign my services apd online?

Yes, and it’s really easy! DocHub is a web-based PDF editor with advanced document management features that allow you rapidly edit your forms, complete empty fields and insert new ones for others to fill out, and create eSignatures in several ways. Upload your services apd, provide information as requested, and select how you want to eSign your document - by typing your name, drawing your signature, uploading its picture, or using a QR code.

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