West Virginia
Family Planning Program

To Become a Family Planning Provider

1. If you are interested in becoming a family planning provider your site must complete and return the Family Planning Program (FPP) Application form. Please note: All FPP clinics must be non-profit and have a Medical Director to oversee the program who holds an MD or DO, licensed in the State of West Virginia (WV) with special experience or expertise in family planning. Verification of clinic type (i.e., Federally Qualified Health Center, Health Department, Freestanding Family Planning Clinic, etc...), non-profit status, and medical director credentials, must be submitted with this application. Applications received without appropriate verification will not be processed.

2. A WV Vendor Application and W-9 form must also be submitted with the FPP Application. All forms must be completed in blue ink. If your site is already a vendor for the state of WV, the Vendor Application and W9 do not need to be completed.

3. Please be aware that an application requires multiple levels of approval before a site can begin providing FPP services. The FPP Director, as well as the Office of Population Affairs and 340B will be involved in the review process.

4. If your site is approved, you will receive a Memorandum of Understanding, as well as a copy of the program guidelines.

5. Once the MOU is signed and returned, the Vendor Application Form and the W9 Form (completed in blue ink) are both sent to DHHR General Accounting and Reporting.

6. After an OASIS vendor number is received, the clinic is issued an FPP ID. A 340B ID number will be provided to the clinic once issued.

7. Clinic sites will then complete the required training and be eligible to begin providing services in accordance with 340B eligibility protocols (e.g., A site may submit an application in August 2025 and be approved immediately but not be able to provide services until January 2026, when they become 340B eligible.)

An application can be found here:https://www.wvdhhr.org/fp/howtobecome_provider.html