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About IDPH

Add New Caregiver

Click the Manage button in the Manage Caregiver(s) section.

Click the Add New Caregiver button (optional) in the Caregiver Information section if you want to add a caregiver.

Enter the required information in the Caregiver Information section.

Select Yes, if you want to fill out the caregiver’s application, and click the Next button.

Notes

  • If you select No for Do you want to fill the Caregiver’s Application, a form is sent to the caregiver’s email address. You will be navigated to the Manage caregivers screen where you can Fill Application, Cancel Caregiver, and Remind Caregiver. Instruct the caregiver to complete the form and submit it.
  • Click the Cancel button if you don’t want to add the caregiver.

Enter the required information in the Caregivers Details section and click the Next button.

Proceed to the Proof of Identity Section and click next.

Review the information entered in the Final Application Review section.

Note: Click the Edit button to modify the information.

Once the application is reviewed, scroll down and click the Submit button.

Note: Once submitted, you will be directed to the Caregiver Information page. A list of added caregivers displays on the page.

Note: As an adult patient you are eligible to add up to three caregivers.

Click the Next button on the Caregiver Information page to continue to the Application Fee section.