Individual Provider Registration: Profile Fields

1. Complete all Contact and Personal Information fields (Note: Required fields are labeled with *)

   1. Gender

   2. Primary Language

   3. Driver’s License information

   4. Home Address

   5. Phone number

   6. Business information if applicable

   7. Preferred Method of Contact

   8. Bio-Providers can enter information about themselves

2. Click Next

3. Enter Languages Spoken

   1. Primary Language Spoken pick list options:

      1. English

      2. Spanish

   2. Secondary Language Spoken pick list of 25 options plus other

   3. Secondary Language Proficiency pick list options:

      1. Beginner

      2. Intermediate

      3. Fluent

   4. Third Language Spoken pick list of 25 options plus other

   5. Third Language Proficiency

      1. Beginner

      2. Intermediate

      3. Fluent

   6. Other Language Spoken

   7. Check if willing to work with an interpreter

   8. Check if user has experience working with an interpreter

4. Click Next

5. Indicate availability status under Accepting New Clients

   1. Answer Yes or No in the Availability section to indicate if you are accepting new clients

   2. Make sure the Service Status is marked Active (if you decide to stop being an Early Intervention Provider you will mark yourself as Inactive and populate the Exit Reason.

   3. If you indicate “No” move on to the next screen by clicking Next

   4. Optional field can be entered under Unavailable Dates and Messages

Note: Users can always go back and update information on this screen. The unavailable dates and messages are most often used for things like maternity leave and vacation.