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New Providers: Your agency or organization can join the Provider Services Network of the Cuyahoga Tapestry System of Care, and help our youth who have the most complicated emotional needs. You will also have access to the wraparound dollars that the Cuyahoga County Board of County Commissioners has invested into the system of care.

Complete all of the following forms (except the MOU) to enroll in the Provider Services Network.

• New Provider Enrollment Form
  • Exhibit A Service Descriptions
    
    
• W-9 Form
  
  
• DMA Form
  • Terrorist Exclusion List
    
    
• Campaign Contribution Certification Form
             
• Review Copy of the Memorandum of Understanding (MOU)
  • This document is for your review only; you do not need to complete and return it. After your application for enrollment in the Provider Services Network is approved in the Cuyahoga Tapestry System of Care office, you will be asked to sign an MOU that looks like the provided sample.

If you are having trouble completing your application documents, or you have other questions about this process, Tapestry staff is available to help. Questions about forms, requirements, etc., should go to Carolyn V. Wood at 216-443-5097. Questions about services, descriptions, etc., should go to Karen Ols at
216-443-6127.

Resources Just for Partner Agencies:
Calendar – Glossary of Terms – Publications – Links