Form IMM-36 New Provider Agreement for Pediatric Sites - New Jersey

Form IMM-36 New Provider Agreement for Pediatric Sites - New Jersey

What Is Form IMM-36?

This is a legal form that was released by the New Jersey Department of Health - a government authority operating within New Jersey. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the purpose of the IMM-36 New Provider Agreement for Pediatric Sites?
A: The purpose of the IMM-36 New Provider Agreement for Pediatric Sites is to establish a contractual relationship between a new healthcare provider and pediatric sites in New Jersey.

Q: Who is required to complete the IMM-36 New Provider Agreement for Pediatric Sites?
A: New healthcare providers who want to provide services at pediatric sites in New Jersey are required to complete the IMM-36 New Provider Agreement.

Q: What does the IMM-36 New Provider Agreement for Pediatric Sites cover?
A: The IMM-36 New Provider Agreement for Pediatric Sites covers important details such as provider information, site information, scope of services, fees, and compliance with regulations.

Q: Can existing healthcare providers use the IMM-36 New Provider Agreement for Pediatric Sites?
A: The IMM-36 New Provider Agreement is specifically for new healthcare providers. Existing healthcare providers may have their own agreement or need to follow a different process.

Q: Are there any fees associated with the IMM-36 New Provider Agreement for Pediatric Sites?
A: Fees may be applicable for the completion and processing of the IMM-36 New Provider Agreement for Pediatric Sites. The specific fees can vary and should be discussed with the pediatric sites.

Q: What should I do if I have questions about the IMM-36 New Provider Agreement for Pediatric Sites?
A: If you have questions about the IMM-36 New Provider Agreement for Pediatric Sites, you should reach out to the relevant healthcare authority or contact the pediatric sites directly for clarification.

Q: Are there any specific regulations or requirements that healthcare providers need to comply with when completing the IMM-36 New Provider Agreement for Pediatric Sites?
A: Yes, healthcare providers must comply with all applicable regulations and requirements set by the relevant healthcare authority and pediatric sites when completing the IMM-36 New Provider Agreement for Pediatric Sites.

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Form Details:

  • Released on March 1, 2017;
  • The latest edition provided by the New Jersey Department of Health;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form IMM-36 by clicking the link below or browse more documents and templates provided by the New Jersey Department of Health.

Download Form IMM-36 New Provider Agreement for Pediatric Sites - New Jersey

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