{"id":19299,"date":"2015-11-18T18:29:30","date_gmt":"2015-11-18T18:29:30","guid":{"rendered":"http:\/\/excelsioripa.com\/?page_id=19299"},"modified":"2015-11-30T21:36:54","modified_gmt":"2015-11-30T21:36:54","slug":"forms-contracts","status":"publish","type":"page","link":"https:\/\/excelsioripa.com\/?page_id=19299","title":{"rendered":"Application Info"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row css=&#8221;.vc_custom_1434202966781{padding-bottom: 16px !important;background-color: #fbfafa !important;}&#8221; el_class=&#8221;no-margin wide padding-row&#8221;][vc_column][vc_column_text el_class=&#8221;no-margin entry-title-section&#8221;]<\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row el_class=&#8221;no-margin-top wide&#8221; parallax_scrolling=&#8221;parallax_scrolling_no&#8221; background_size_cover=&#8221;background_size_cover_no&#8221;][vc_column]\t\r\n\t\t\r\n\t\t\r\n\t<div id=\"block-portfolio\" class=\"default-width  clearfix\" data-columns=\"col4\">\r\n\t\r\n\t\t\t\r\n\t\t<div class=\"mt-loader spinner3\"><div class=\"bounce1\"><\/div><div class=\"bounce2\"><\/div><div class=\"bounce3\"><\/div><\/div>\r\n\t\t<div id=\"portfolio\" class=\"col4 title-visible portfolio-text-left margin20 mt-animate_when_almost_visible-disabled portfolio-50-width-disabled clearfix\">\r\n\t\t<div class=\"grid-sizer\"><\/div>\r\n\t\t<div class=\"gutter-sizer\"><\/div>\r\n\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19321\" class=\"clearfix post-19321 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Minimum-Qualifications-Criteria.pdf\" target=\"_blank\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/10\/EMIPA-Minimum-Qualifications-Criteria.png?fit=1010%2C1304&amp;ssl=1\" width=\"1010\" height=\"1304\" alt=\"EMIPA Minimum Qualifications Criteria\" title=\"EMIPA Minimum Qualifications Criteria\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>EMIPA Minimum Qualifications Criteria<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19321 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19320\" class=\"clearfix post-19320 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Standard-Application-Form-20140723.pdf\" target=\"_blank\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Standard-Application-1044x1310.png\" width=\"1044\" height=\"1310\" alt=\"EMIPA Standard Application\" title=\"EMIPA Standard Application\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>EMIPA Standard Application Form<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19320 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19323\" class=\"clearfix post-19323 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Application-Documents-Checklist.pdf\" target=\"_blank\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Application-Documents-Checklist-1044x1310.png\" width=\"1044\" height=\"1310\" alt=\"EMIPA Application Documents Checklist\" title=\"EMIPA Application Documents Checklist\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>EMIPA Application Documents Checklist<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19323 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19713\" class=\"clearfix post-19713 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Application-Process-Overview.pdf\" target=\"_blank\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/application-process-overview-1124x1310.png\" width=\"1124\" height=\"1310\" alt=\"EMIPA Application Process Overview\" title=\"EMIPA Application Process Overview\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>Application Process Overview<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19713 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19719\" class=\"clearfix post-19719 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/?portfolio=authorization-release-and-attestation\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/authorization-release1-1163x1310.png\" width=\"1163\" height=\"1310\" alt=\"Authorization, Release and Attestation\" title=\"Authorization, Release and Attestation\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>Authorization, Release and Attestation<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19719 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19715\" class=\"clearfix post-19715 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Credentialing-Process-Overview.pdf\" target=\"_blank\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/credentialing-process-overview-1150x1310.png\" width=\"1150\" height=\"1310\" alt=\"EMIPA Credentialing Process Overview\" title=\"EMIPA Credentialing Process Overview\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>Credentialing Process Overview<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19715 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19322\" class=\"clearfix post-19322 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Insurance-Opt-in-Form.pdf\" target=\"_blank\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Insurance-Opt-in-1124x1310.png\" width=\"1124\" height=\"1310\" alt=\"EMIPA Insurance Opt-in\" title=\"EMIPA Insurance Opt-in\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>EMIPA Insurance Opt-In Form<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19322 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t<article id=\"post-19350\" class=\"clearfix post-19350 portfolio type-portfolio status-publish has-post-thumbnail hentry element \">\r\n\t\t\t\t\t\t\t\t<a class=\"content-wrapper\" href=\"https:\/\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/2015-EMIPA-Slideshow-Website.pdf\" target=\"_blank\" >\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"post-thumbnail clearfix\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<img decoding=\"async\" class=\"\" src=\"https:\/\/i0.wp.com\/excelsioripa.com\/wp-content\/uploads\/2015\/11\/EMIPA-Factsheet.png?fit=1396%2C1046&amp;ssl=1\" width=\"1396\" height=\"1046\" alt=\"EMIPA Factsheet\" title=\"EMIPA Factsheet\" loading=\"lazy\" \/>\t\t\t\t\t\t\t\t\t\t<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<header class=\"entry-header portfolio-data\">\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h2>2015 EMIPA Factsheet<\/h2>\r\n\t\t\t\t\t\t\t\t\t\t\t\t<\/header><!-- .entry-header -->\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<div class=\"entry-excerpt\"><p>Download PDF<\/p>\n<\/div>\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/a><!-- .content-wrapper -->\r\n\t\t\t\t\t\t\t<\/article><!-- #post-19350 -->\r\n\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t\r\n\t\t<\/div><!-- #portfolio -->\r\n\t\t\r\n\t\t\t\t\r\n\t\t\t\r\n\t<\/div><!-- #block-portfolio -->\r\n\t\r\n    [\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row css=&#8221;.vc_custom_1434202966781{padding-bottom: 16px !important;background-color: #fbfafa !important;}&#8221; el_class=&#8221;no-margin wide padding-row&#8221;][vc_column][vc_column_text el_class=&#8221;no-margin entry-title-section&#8221;] [\/vc_column_text][\/vc_column][\/vc_row][vc_row el_class=&#8221;no-margin-top wide&#8221; parallax_scrolling=&#8221;parallax_scrolling_no&#8221; background_size_cover=&#8221;background_size_cover_no&#8221;][vc_column][\/vc_column][\/vc_row]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-19299","page","type-page","status-publish","hentry","element 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