Information, Forms, & Documents

for New Inspired Team Members

 

Please provide the following*:

  1.  A completed IRS form W-9 (All) (Gusto)

 

   2.  A completed I-9 form, with appropriate copies of your identification, as listed on the form (All) (Gusto)

 

   3. A completed IRS form W-4 (All) (Gusto)

 

   4. A signed Employee Care of Confidential Information form (All) (Gusto)

 

   5. A completed CORI Acknowledgment Form (All)

 

   6. A copy of your Massachusetts license to practice (where applicable) (T)

 

   7. A short bio for use on Psychology Today. You may find a sample one here (T)

 

   8. Permission for your direct deposit (All) (Gusto)

 

   9. The signed Acknowledgment page from Theraspire's Employee Handbook  (All)

 

 10. You will need to apply for, and furnish Theraspire with, an NPI number (T)

 

 11. You will need to create a CAQH profile and provide Inspired with your sign in credentials. This will               allow Theraspire Collective LLC to access the information for insurance credentialing at Theraspire.           (T)

 

*T=Therapist, A=Admin, All=All Team Members

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© 2020 by Michelle Ruprecht. All Rights Reserved.

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