Get In First Steps Annual Credential Form 2021-2025

Filling out the IN First Steps Annual Credential Form online can seem daunting, but with this guide, you can complete the process efficiently and accurately. This comprehensive guide provides step-by-step instructions tailored to your needs, ensuring you understand each section of the form.

Follow the steps to complete your credential form successfully.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by filling in your personal information in the 'Personnel Information' section. This includes your name, email address, phone number, and any previous names if applicable. Ensure that you provide accurate information as this is mandatory.
3. Select your current role from the given options, such as service provider, agency director, or other roles. Provide your discipline and, if applicable, a second discipline. Additionally, complete fields for your professional license type, license number, and expiration date.
4. Provide your National Provider Identifier (NPI) number, as this is necessary for all providers. Also, indicate the current date of your criminal history inquiry.
5. If you are a COTA or PTA, complete the supervision agreement section. Include the supervisor's details, such as name, phone number, discipline, email, license number, and attach their license and First Steps credential.
6. Document your trainings by entering the relevant details. You may duplicate this page as necessary, ensuring you list the titles of training, hours completed, and competency areas. Remember, a total of 15 hours of professional development related to early intervention is required.
7. Once all sections are completed, review your entries for accuracy. Sign the attestation statement, affirming that the information is true and correct. Ensure to print your name, sign, and date this section.
8. After finishing the form, you can save changes, download the document, print it, or share it as required. Ensure that all necessary supporting documentation is included before submission.

Complete your IN First Steps Annual Credential Form online today to ensure your credentials are timely and accurate.