CCSN Providers
We are excited that you have joined our family of providers, it is our goal to provide quality care to our families.
As a member of our team, you will be working with some very wonderful people who are all unique in their own way. They
will definently enrich your life in ways that you could never have imagined.
Now that you have completed your training, it is time to start contacting families.
Once you make contact with a family, you must print these forms off and take them to the original family meeting. If
you and the family decide that you will begin providing services, then you must have the family fill them out and
you need to fax them to your area program director BEFORE you begin services.
Once the program director has had the hours approved, you may begin providing services. When the area director
contacts you about starting services, you will be provided with the information to acces all of our forms.
PLEASE NOTE: If you provide
services before the hours have been approved you run the risk of NOT getting paid for those hours.
Service Forms
For Pima and Cochise Counties: Tracey Glenn
Intake 1 (on-line word doc)
Intake 2 (on-line word doc)
Intake Information (on-line word doc)
General Consent (on-line word doc)
emergency contact (on-line word doc)
Steps to follow BEFORE starting services
- Make contact w/family for appointment
- Print off papers
- Have family fill out paperwork
- Fax paperwork to area director
- Wait for hour verification
- Get your forms password from director
- Start Services
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