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Registration Form Course Date Requested (check one)July 14, 2017 (Refresher Course) July 1516, 2017 (Initial Provider Course)(Refresher candidates must provide a copy of ATLAS provider Card) (Please
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What is refresher candidates must provide?
Refresher candidates must provide updated information or documentation.
Who is required to file refresher candidates must provide?
Anyone who needs to renew or update their information.
How to fill out refresher candidates must provide?
Fill out the required forms or online application with the updated information.
What is the purpose of refresher candidates must provide?
The purpose is to ensure that all information on file is current and accurate.
What information must be reported on refresher candidates must provide?
Any changes to personal information, qualifications, or certifications.
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