Become a Vendor

Are you interested in being a vendor for us?

If you are thinking about becoming a service provider or vendor to vocational rehabilitation clients please follow the step-by-step instructions and contact a Division of Vocational Rehabilitation office.


Step by Step to Become a Vendor


Required Forms to Complete

Required Forms:

Send your final forms first to your local office contact.

1. Vendor Registration Form
2. Completed W-9 Form (you must email: to obtain this form)
3. Copy of all Qualifications/Credentials (as applicable, listed in Appendix A of the Fee Schedule)
4. Copy of Insurances (as applicable; Professional, General Liability, Workers Compensation)
5. Copy of auto insurance and driver’s license if providing transportation services
6. Completed EFT Authorization Form
7. Voided check or letter from your banking institution with a bank representative signature verifying your
account and routing number
8. Résumé, as applicable