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Notification to Update Pearson Online Classroom Account Information or Request Contract Updates
This form may be used to notify the vendor management team of a change:
therapist's name
therapist's e-mail address
therapist's availability (hours per week)
therapist's extended absence
therapist needs to have account reactivated
Completion of this form allows PVS to update the therapist's display name in the online classroom, update the therapist's e-mail address in the online classroom (for the purpose of IA notification alerts), notify Connexus Management of an extended absence (to prevent deactivation of the account), or reactivate an account for a therapist who has resumed services.
This form may also be used by vendors to request contract adjustments such as legal entity name changes or contract amendments.
This form is no longer used for resignations. To notify the Operations team of a resignation, please use the
Therapist Resignation Form
.
Email
*
Please enter your current e-mail address (not the therapist's e-mail address if you are submitting this form on the behalf of someone else). This information will be used to contact you if further information is needed.
Update Account Information for Therapist/Evaluator
If you are submitting this form on behalf of a therapist/evaluator, please select the type of update needed for the therapist's account. If the provider has resigned or is going on an extended absence and needs to have their caseload transferred to another therapist/evaluator, please also fill out the
Sectioning Request Form
.
Name Change
E-mail Address Change
Extended Absence (beyond 30 days)
Therapist Availability
Restore Provider System Access to serve students
Update Location Access in POC
Update Contract Information
If you are a business owner or vendor main contact and need to request a contract adjustment, please check the box below to indicate the type of contract change being requested.
Increase PO Amount
Legal Entity Name Change (business owners only)
Request Adjustment in Rates
Request Contract Amendment to Add Service(s)/Evaluation(s)
Ticket name
*
Please enter the therapist name and the school that they serve when creating this ticket name.
Ticket description
Please enter any additional information that will be helpful for the team to provide support.
Submit