​Submit Change to Age Served

​Providers may can request update to their age of children being served your existing agreement. 
​
When submitting this request, please ensure the following information is provided:
*Provider Details
*Authorized Representative
*Effective Date
*New Ages Under Contract
*Removed Age Under Contract

* Changes are not retroactive
*Incomplete requests may delay processing 
*Need to also adjust Pay Rate to process

By submitting this form, you are requesting a change in your Ages Served. All Requests are subject to review and verification.

Age Served

Provider Details

Authorized Representative

Change Type

(Removing) Ages Not Under Contract

(Adding) Ages Under Contract

I understand that I must make a Pay Rate Change if adding or removing ages served.

I certify that the information provided is accurate to the best of my knowledge.

You can upload a maximum of 1 file, up to 48MB. Supported files include image, .doc, .dot, .wbk, .docx, .docm, .dotx, .dotm, .docb, .xls, .xlt, .xlm, .xlsx, .xlsm, .xltx, .xltm, .ppt, .pot, .pps, .pptx, .pptm, .potx, .potm, .ppam, .ppsx, .ppsm, .sldx, .sldm, .pdf.

Submit a Pay Rate Change

After Submission

After submission, your inquiry is forwarded to our team and assigned to a dedicated Provider Coordinator who will begin processing it.

Processing 

Our support team responds to all changes within 48 hours. For urgent issues, contact our hotline. Approved Pay Rates are updated in Kinder Systems.

Confirmation

Providers may receive confirmation once the Pay Rate has been updated, or be contacted if additional information is needed.