Vendors
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Forms and Other Resources

Vendor Applications

VR Standard Vendor Application
Other vendor applications:

* Requires background screening.
** Go to Background Screening for requirements.

Current Vendors

Vendor Maintenance

Vendor approval letters include the expiration date and requirements to continue as an approved provider.

Vendor Information Update Process (PDF)
This process is used for updating mailing or remittance addresses only.

Direct Deposit Form (PDF)
Must be mailed and include the original signature to the Department of Financial Services (DFS). DFS will not accept a fax or email. Forms received by Vendor Registration will not be forwarded.

Vendor Information Update Form (PDF)
Used for VR vendors who need to update their name, address or contact information.

Vendor Re-Registration Process (PDF)

Change a Vendor Number (Tax/SSN) (PDF)

Vendor Withdrawal Form (PDF)
Used by registered vendors who no longer wish to provide services for VR or for any company who wishes to remove a provider who has recently terminated their employment.

Vendor Resources

My Florida Marketplace Quick Reference Guide (PDF)

Vendor Qualifications Manual (PDF)

VR Medical Provider Presentation (PowerPoint)
Group Medical Providers of two or more health care providers licensed by the Florida Department of Health legally organized as a partnership, professional corporation or similar association.

Vendors who work with individuals who are Deaf, Late-Deafened, Hard of Hearing or Deaf-Blind

On-the-Job Training