|
Domestic
Employee Application
|
|
|
| To Whom It May Concern, One of the greatest limitations that we experience is the shortage of providers willing to provide services to the individuals and families that we serve. We appreciate your interest in becoming a Qualified Provider for Self-Determination Resources, Inc. (SDRI). Enclosed in you will find all the paperwork required to enroll you as a Qualified Provider, including a handy checklist of all required elements. Please note that in addition to completing the paperwork enclosed; if you'll be driving customers in your personal vehicle, we will need a copy of your valid driver's license and auto insurance card. Hopefully, you will use the checklist when mailing everything back to SDRI so everything is included and we can get you qualified with a minimum of correspondence and fuss. A self-addressed envelope has been provided to expedite the return of this paperwork. We need to have a resume on file for all providers. If you have a current resume please include it in the papers you return to us. If you do not have a resume, please use the sheet enclosed to provide us with your relevant skills, employment/experience and education. Oregon Rules also require we do a reference check. Please complete the reference request form. If you have at three references listed on your resume, you do not need to complete the reference request form. One of the necessary components for qualifying as a provider is a criminal history check. Until we receive the criminal clearance from the Department of Human Services Criminal Records Unit, we can neither authorize nor pay you for any work performed before the date of the clearance. We encourage you to submit your criminal history check promptly as it takes approximately 4-6 weeks for the application to be processed. We want to use your services as soon as possible. If you have any questions about filling out this paperwork, please give us a call at 503-292-7142. You can also email our office manager, Kitty, at kitty@sdri-pdx.org with any questions that may arise. Again, we thank you for your interest in becoming a Qualified Provider with us. We look forward to working with you to provide quality service to our customers. |
| Included in the Domestic Employee packet: |
Click on any of the above links to view, download, save
and/or print them individually. (Note: If you download the .ZIP file, you will need a program capable of opening and decompressing .ZIP files, in addition to programs capable of reading documents in Adobe Acrobat .PDF format and in Microsoft Word .DOC format in order to view, edit or print the above documents.) |
| Complete, sign, then mail in an envelope addressed to SDRI: |
|