FREE THROUGH RECOVERY (FTR) PROGRAM PROVIDER APPLICATION - North Dakota State Government 2026

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  1. Click ‘Get Form’ to open the FREE THROUGH RECOVERY (FTR) PROGRAM PROVIDER APPLICATION in our editor.
  2. Begin by filling out the 'Program Information' section. Enter your Provider Name, Address, City, State, and contact details including telephone and email addresses.
  3. Proceed to 'Additional Locations' if applicable. Provide similar information for any additional provider locations you wish to include.
  4. In the 'Services' section, ensure you check all services you will provide for monthly reimbursement, such as Care Coordination and Peer Support.
  5. Attach required documents in the 'Attachments' section. Ensure all necessary agreements and verifications are included.
  6. Finally, complete the 'Signature' section by certifying that all information is accurate and signing where indicated.

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