How to Become a Respite Provider

Thank you for your interest in becoming a respite provider.  In order to become an approved provider for the Nebraska Lifespan Respite Network, please take the following steps:

  • Complete the Individual Provider Application - If you provide respite for only one family and do not wish to be referred to others, please note that at the top of the application.  The application should be mailed to WCHR/Respite, 300 Shelton Street, Chadron, Ne 69337.  Please note on your application if you are also a Medicaid approved provider.
  • Log on to and create an account.  Then scroll down to the Nebraska Lifespan Respite Provider Orientation and complete each section.  There is a quiz at the end of the orientation that must also be completed.  You will receive a certificate after the quiz has been submitted.
  • Send a copy of your driver's license or state issued ID with your paperwork.
  • Once we have received your application and reference forms and you have completed the online orientation, an email will be sent to you from . This is how we complete the background check process.  It is very important for you to complete the steps in the email. 

When you have completed these steps, you are a Network Screened Provider and eligible for payment through the Lifespan Respite Subsidy Program and our grant funded Respite Days Program.  There are many other agencies who use independent providers.  If you are interested in working with another agency to increase your potential for referrals, click here.

We look forward to having you as one of our providers. 

Connect With Us!
  • 866-RESPITE (737-7483)
  • 308-432-8190
  • Visit the Nebraska Respite Network Website at
  • "like" us on Facebook - Nebraska Lifespan Respite Network, Panhandle Partnership for Health and Human Services and Western Community Health Resources pages all share information on respite.