Forms

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.

Enrollment Packets and Forms

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

Fiscal Employer Agent (FEA) Services – Serving an Adult Member
Services authorized by Care 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 County or North Central Health Care

Co-Employment Services – Serving an Adult Member
Services authorized by Care Wisconsin

Co-Employment Services – Serving an Adult Member
Services authorized by Community Care, ICare, Inclusa, or Lakeland Care