Provider Application

Please complete all sections of this application.

Step 1. Complete and save the Mainspring Academy Provider Policy.

(Laptops/Desktop Only)


Step 2. Upload your Provider Policy.

Step 3. Upload your Level 2 Background Check

The Florida Department of Law Enforcement Level 2 Criminal History Record Checks is used in Florida Statutes to convey the method of the criminal history record check and the extent of the data searched. Level 2 describes a state and national fingerprint-based check and consideration of disqualifying offenses and applies to those employees designated by law as holding positions of responsibility or trust.
Step 3. Upload a Recent Headshot

Required. Please upload an appropriate clear and recent headshot for our provider records. Many outside agencies provide services at Mainspring Academy. This will assist our rotating office staff in identifying you.
Step 4. Ensure Parents Have Completed, Signed, and Submitted the Permission for In-School Services Form

*If the parent has not already submit this to the School, you may upload completed and signed Parent Permission forms here.
Step 5. (ABA Case Managers Only) Upload a copy of client treatment plan(s)

Therapists may not provide services at Mainspring Academy until the school has received a Permission for In-School Services form from the student's parent. In addition, services at Mainspring Academy may not be provided until this application is reviewed and approved by the school's Director of Programming.