New Providers Application Process for Choice, SSBG and Title 3 Programs

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• Complete new provider application packet and return as indicated on the packet checklist.

• New providers must currently be serving at least one client under another funding source to be considered for application.

• The establishment of a contractual agreement provides no guarantee of referrals for service delivery.

• Request for a complete application packet, including the contract, and any questions can be directed to:

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Beth Krudop, VP of Administration
AIHS
8101 W. Jefferson Blvd.
Fort Wayne, IN 46804

Or via email at info@agingihs.org.