The Preventive and Protective Child Care Invoice (Form 2636, 2 pages) is an invoice form submitted by child care providers to receive payment for providing care to children for preventive and protective child care services. The invoice form includes detailed instructions to assist providers with its completion.
The invoice form must be completed accurately and fully. An invoice should be submitted bi-monthly. For payment to be made the invoice must be submitted no later than 90 days after the delivery of service. Incomplete or illegible invoices will be returned, and payment may be delayed. The invoice must have original provider signature.
When printing this form from the DHHS Website, the provider should make and keep a photocopy. One invoice should be used for each child. |
