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02/19/2008

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Affiliation Request

 Two Part Process - If you are not a Nationwide Provider - Click Here

First Part

Print and Submit the Release form Prior to Proceeding. Release for Criminal Background Investigation Form

 

To avoid misunderstandings, please submit your application fee through PayPal first.

After submitting the application fee, you will complete the actual application.

It is in your companies interest to print the application for review prior to proceeding.

 For a printable application to review, click here. http://www.sirs4quality.org/files/AFA1.pdf

 

Once your company reviews the application, you may return here to begin the on-line process.

There are no processing fees added for using your credit card.

 

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