Provider Knowledgebase Application

Thank you for your interest in being a provider listed within the Help Me Grow North Texas FINDconnect system. Please provide the following information and submit for review. Your application will be immediately sent to the Help Me Grow North Texas Centralized Access Program Director, who will contact you within 2 weeks to confirm or deny your application. This form can also be used for providers that are already listed within the FINDconnect system that wish to update their entry. Prior to completing your application, please review the Help Me Grow Inclusion/Exclusion Policy on our Help Me Grow North Texas website under the Providers tab to ensure your program meets criteria for FINDconnect. Feel free to email any questions to info@helpmegrownorthtexas.org.

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Is this entry for a new application into FINDconnect or information update?
Name of Person Submitting Application(Required)
Services Provided(Required)
Enter any services provided through this program. To add additional services, click +
Organization or Program Contact
Organization or Program Address(Required)
Check Counties Served(Required)
If only serve certain ISDs, zip codes, or cities within a county, list here
List all insurances accepted for billing
Provide any additional information regarding the services of the organization or the program mentioned in this application.
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