PROVIDER TIME STUDY INSTRUCTIONS
PROVIDER FORMS
01 – Provider Application
02A – Provider Entity Disclosure of Ownership
02B – Provider’s Subcontractor Disclosure of Ownership
03 – False Claims Attestation
04 – Federal Form W9
05 – Contracted Entity Management/Control Background Check Release Form
06 – Contracted Provider Insurance Requirements
07 – Workman’s Compensation Exclusion Statement
08 – Provider training Material & Manual Attestation
09 – Provider EFT Vendor Authorization for Direct Deposit
10 – Provider NorthStar User Verification Form
11 – Provider NorthStar System New User Request Form
