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Consumer Direct Care Network Virginia

FORMS

Please download the relevant forms, print, fill out, and send them to InfoCDVA@ConsumerDirectCare.com. For any assistance, feel free to contact us.

Certain forms are available in Spanish. Look for the icon and select your preferred language as Spanish from the top menu to view translated versions.

Attendants

Attendants, or caregivers, are the people hired to provide care or support. Fill out these forms if you are an Attendant.

Enrollment Packet / Forms

Electronic Attendant Enrollment Packet (recommended-fastest way to enroll and get paid)

Printable Attendant Enrollment Packet (slowest way to enroll)

Electronic Attendant Transition Enrollment Packet(recommended-fastest way to enroll and get paid)

Printable Attendant Transition Enrollment Packet (slowest way to enroll)

Attendant Data Form

Attendant Employment Agreement

SP-167 Criminal History Records Request

Live-In Exemption Form

Form/Packet Instructional Materials

Attendant Enrollment Packet Instructions

Attendant Enrollment Packet Instructions 🌐

Watch Video

DocuSign User Guide Attendant 🌐

Secure Email Proofpoint 🌐

I-9 Instructions Sections 1-2 🌐

Payroll Related Forms

2025 Payroll Calendar 🌐

2026 Payroll Calendar 🌐

IVR Registration 🌐

W-4

VA-4

Caregiver Pay Selection Form

Wisely Poster 🌐

ADP Registration Instructions

W-2 Frequently Asked Questions

Employers of Record (EOR)

EORs act as the employer. An EOR can be the person receiving the services, or someone else they choose. Fill out these forms if you are the EOR.

Enrollment Packet/Forms

Electronic Employer Enrollment Packet (recommended-fastest way to enroll)

Printable Employer Enrollment Packet (slowest way to enroll) 🌐

Electronic Employer Transition Packet (recommended-fastest way to enroll)

Printable Employer Transition Enrollment Packet (slowest way to enroll) 🌐

Consumer Data Form 🌐

Authorized Rep Agreement

Change of Employer of Record

Electronic Employer Enrollment Packet (recommended-fastest way to enroll)

Printable Employer Enrollment Packet (slowest way to enroll) 🌐

Employer of Record Change Attendant Attestation Form 🌐

Form/Packet Instructional Materials

Employer Enrollment Instructions 🌐

Watch Video

Employer Enrollment Packet Instructions

DocuSign User Guide

Employer Packet Instructions 🌐

Payroll Related Forms

2025 Payroll Calendar 🌐

2026 Payroll Calendar 🌐

Designated Representative for Attendant Time Approval

Additional Materials

Blank - Notice of Discontinued Employment (NODE)

Attendant Contact Information Change Form

Feedback Form 🌐

Fraud Brochure 🌐

IVR Registration 🌐

Service Facilitators

Service Facilitators help Consumers and their families. Fill out the Fiscal Agent Request Form if you are a Service Facilitator.

Forms

Fiscal Agent Request Form - Online Packet

Fiscal Agent Request Form - Printable Packet

Completing the Fiscal Agent Request Form

Service Facilitator Confidentiality Agreement

Consumer Direct Care Network Virginia

FORMS

Attendants

Employers of Record (EOR)

Service Facilitators

I want to enroll or help my Consumer enroll in services.

I want to approve time submitted by my Attendant(s).

I am a new Employer of Record and want to enroll myself or my Consumer in services.

I want to understand my pay.

I want to help my Consumers enroll in services.

My Consumer has changed their employer.

I'm a new Service Facilitator and want to learn more.

My Consumer is new to Consumer-Directed services.

My Consumer is transitioning from another F/EA.

The final payday in 2025 for CDVA will be on December 19, 2025.

I want to manage my agency information in CDVA’s system.

I want to see the status of my Consumers’ paperwork.

I'm an Employer of Record/Personal Representative.

I'm an Attendant.

I'm a Service Facilitator.