Click this link to upload the Memorandum of Understanding for Monmouth County. It is a Survey Monkey document. You will need to have complete information on all your staff including licenses, certifications, areas of strength, and more. You will also need to have Medicaid provider information, if you are a Medicaid provider and know your CYBER ID Number. You will also need information on all insurance panels. If you are not a Medicaid provider, you will still need to obtain a CYBER ID Number from PerfomCare.
We suggest you print out a blank copy of the document before you attempt to complete it online to gather the information you need.
You will also need to submit supplemental information to the special fax number included in the document. It is a digital fax repository. We will not accept hard copies of either the MOU or supplemental information in our office.
All MOU applicants need to enter their information on the MonmouthResourceNet go to monmouthresourcenet.org. If you are already entered on the site, please be sure your information is current and correct.
Once the MOU form has been submitted and your MonmouthResourceNet entry is current, we will review it and if you are accepted, we will email you an acceptance document for you to sign and return to the digital fax repository.