For information on the CDPAP transition to PPL Click here

CDPAP Registration Session Interest Form

  • A
  • A
  • A

CDPAP Registration Interest Form

Name(Required)
Consumers: I have confirmed with PPL HCS as my CDPAP facilitator(Required)
Consumers: I have access to my Medicaid number (CIN)(Required)
PAs: I have access to required documentation and my client's CIN(Required)
I/we prefer to be contacted by(Required)