Attached is a model that our private provider association has shared. It is loosely based on the HUD 811 document. It was noted that the provider association does not give
legal advice and providers should vet the agreement carefully for consistency with their own state’s and the federal requirements. Heidi
Heidi Lawyer
Executive Director
Virginia Board for People with Disabilities (VBPD)
1100 Bank Street, 7th Floor, Richmond, VA 23219
804-786-9369
800-846-4464
www.VaBoard.org