If you would like to become a provider for the TBI Fund, please click on the “Vendor Application,” fill out the required information and upload the necessary documentation.

Vendor Application

Before you apply, please make sure you complete the following steps.

1. Register your business on NJ START (the State eProcurement system).
   1. This registration must contain the proper legal name of the organization doing business with the State of New Jersey and any trade name certificates updated to the system.
   2. For questions regarding this registration process, you may contact a New Jersey state vendor administrator at (609) 341-3500 or njstart@treas.nj.gov.
   3. Please keep your contact information up to date in NJ Start.
2. In the application, please provide a summary of detailed services with the corresponding CPT codes, along with the total cost of each session (30 mins or 60 mins only, do not use 15min increments) or each item.
3. Provide a copy of all clinical licenses or certifications in pdf format.
4. Provide proof of insurance in pdf format.
5. Provide copies of either a Curriculum Vitae or resume for everyone who will be performing the service in pdf format.
6. If you use a third party service to handle your billing, please submit a contact who performs this function on your behalf in the designated area on the application form.