Forms are available for you to download and complete as you need them. If you are unsure on how to complete a form or are unable to find what you need, please contact the Consumer Direct Care Network Wisconsin office at 877-785-9991.
Forms
Enrollment Packets and Forms
Member Enrollment Packets
Fiscal Employer Agent (FEA) Services – Adult Member Packet
Family Care authorized by a Managed Care Organization
Fiscal Employer Agent (FEA) Services – Minor Child Member Packet
Children’s Long Term Care authorized by a County or North Central Health Care
Co-Employment Services – Adult Member Packet
Family Care authorized by a Managed Care Organization
Fiscal Conduit/Vendor Services – Adult Member Packet
Family Care authorized by a Managed Care Organization
Employee (Caregiver) Enrollment Packets
Fiscal Employer Agent (FEA) Services – Serving an Adult Member
Services authorized by My Choice Wisconsin
Fiscal Employer Agent (FEA) Services – Serving an Adult Member
Services authorized by Community Care, ICare, Inclusa, or Lakeland Care
Fiscal Employer Agent (FEA) Services – Serving a Child Member
Services authorized by Barron, Chippewa, Dunn, Eau Claire, Jackson or Marathon County; or North Central Health Care
Fiscal Employer Agent (FEA) Services – Serving a Child Member
Services authorized by Kenosha County
Co-Employment Services – Serving an Adult Member
Services authorized by My Choice Wisconsin
Co-Employment Services – Serving an Adult Member
Services authorized by Community Care, ICare or Inclusa