The following forms are provided as a resource for contracted service providers:
- Billing Manual. The Billing Manual is now located within Maine Child Information Network Connection (CINC). To access the information you must log into CINC.
- Billing Invoice (XLS, 38KB). This is the preferred Child Development Services billing invoice for those services not required to be billed through CINC. It serves as an example to demonstrate the information required on invoices submitted to CDS for payment. CDS does accept HIPPA forms if they are augmented to include all information seen in this template. All contracted service providers must submit a monthly invoice for each child served. Invoices must be mailed at least monthly.
- IRS W-9 and ACH/EFT Authorization. All new contracted providers must provide CDS with a completed form W-9 before first payment will be processed. We encourage all contracted providers to take advantage of electronic funds transfer (ACH/EFT) payment option. In order to begin receiving ACH/EFT payments, CDS must receive a completed authorization form. Forms should be mailed to the CDS State Office.
- IRS W-9 Form (PDF, 85KB)
- ACH/EFT Authorization Form (RTF, 226KB)
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Progress Monitoring Form (DOCX, 71KB). Use this form to meet the written progress report requirement. Progress reports shall describe the child's progress toward the goals in the child's IEP. For children with disabilities ages three to five, quarterly progress reports will be based on the CDS Academic Calendar.
- Authorization to Request and/or Share Information and Records (PDF, 73KB). CDS applies the Family Educational Rights and Privacy Act (FERPA) regarding confidentiality of child records and may not share information without written permission from the parent or guardian. If you would like to request information, please submit the Authorization to Request and/or Share Information and Records form signed by the parent or guardian to the regional CDS office serving the child (if known) or the CDS State Office.