Where innovative healing, teaching, and discovery come together.
Visit our Location
44 Varet Street, Brooklyn, NY
Give us a Call
(718) 388-0220
Hours
M-F: 9A-5P | On-call 24/7

 

Fields marked with an * are required

CDPAP – RFO Subcontracting Questionnaire


Join us on this journey. Provide us a response to the following questions.


Name of your organization? *

Contact Person *

Contact Person Title *

Contact Email *

Contact Telephone *

Main Office Address *

City *

Zip Code *

Do you have an organizational chart? *

Please upload your organizational chart

Are you under audit by the state or the federal government?

What languages do you currently service?

Are you presently serving CDPAP consumers?

How long have you been providing CDPAP services?

How many CDPAP consumers are you currently serving?

In what counties are you serving clients?

How many years have you been serving disabled individuals?

How big is your disabled-consumer population?

Please upload the collaborating partner agreement – Attachment C