Welcome to BURD Home Health's secure information gathering form. The following form will be used to gather the necessary information needed to begin your transfer process with PPL and ensure there are no disruptions in your CDPAP services.

Please Note: There are multiple steps to complete the transfer to PPL. Submitting this information is the first step to verify your eligibility for continued CDPAP services. You should continue to work with your current FI until you have been notified by PPL of your CDPAP transfer date. Transfer dates are tentatively scheduled for March 1st and March 28th.

Upon completion of this form, a member of BURD Home Health will contact you to complete the next steps for PPL enrollment.

Select 'Next' to begin.
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