Provider Enrollment
To become a provider qualified to contract with SDRI, you must complete a provider enrollment packet and submit it via fax or mail to SDRI. Incomplete applications will not be processed.

There are primarily two types of providers, Domestic Employees and Independent Contractors. You must decide which type of provider that you would like to be before you begin the application process. To review the differences between these provider types, please visit the Provider Types portion of our site.


 


Mail your application to:
Self-Determination Resources, Inc
1730 SW Skyline Blvd, Ste 127
Portland, OR 97221-2548
 
OR
 
Fax your application to:
(503) 292-0298


Once we receive completed provider application forms, we will start the qualification process. Because this process is dependent on the State of Oregon processing the applicant's criminal history, it can take several weeks to become qualified. Please fill out all forms clearly and completely to avoid any unnecessary delays. Upon receipt of your completed application, we will send you additional information about the provider position.


If you have any questions about the application process,
please contact us at: (503) 292-7142