Provider Service Forms

*If you are looking for a New Provider Enrollment Packet, you can find it Here.

*If you are looking for blank Time Sheets, you can find them by clicking Here. (Note: The eXPRS generated time sheet is required when submission to our office for payment. This document is not acceptable, and is more of a draft).

* If you are looking for blank Mileage Reimbursement Logs, you can find them by clicking Here. (Note: The eXPRS generated mileage log is required when submission to our office for payment. This document is not acceptable, and is more of a draft).

* If you need to file a Incident Report, you can do that by clicking Here.

*If you need to fill out a W4 you can find it Here

*If you need to fill out an I9 you can find it Here .

*If you need to fill out an eXPRS Employee Change form, you can find it Here.

*If you need to fill out a PEAA (Provider Enrollment Application and Agreement) click Here. Para el Espanol, clic Aqui.

*If you need to fill out an eXPRS UEF (User Enrollment Form) click Here .

*If you need to update your Criminal History Check you can find the form Here. (In order to process you will need to come into the CSI office in person with a valid ID) Para el Espanol, clic Aqui.

*If you need to view the State Payroll Calendar click Here .