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How to Submit Provider Rights and Responsibilities

You should have received a letter that will contain a temporary password.  You will need the temporary password in order to log onto the Rights and Responsibilities submission site.  Please follow the steps below, in order to complete and submit the agreement electronically:

1.    Go HERE.

2.    The next screen will require you to enter your PS#, and your password.

3.    Upon successful sign in, a subsequent screen will display a list of all CCUBS facilities for which you are currently the director.  Each facility link will indicate if a Provider Rights and Responsibilities agreement form is required or has already been completed.

4.    Click on each facility link that indicates an agreement is required.  A Provider Rights and Responsibilities agreement will be displayed, requiring you to check the box indicating your understanding and agreement with each statement.

5.    Click submit.

6.    Use the print icon to print a copy of the Provider Rights and Responsibilities for your records.

If you are having any difficulties, please contact us at 761-6010 with any questions you may have!