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Get State Of Wisconsin Dhs Informed Consent

DEPARTMENT OF HEALTH SERVICES Division of Long Term Care F-20941A 05/2010 STATE OF WISCONSIN INFORMED CONSENT FOR PARTICIPATION IN WISCONSIN MONEY FOLLOWS THE PERSON REBALANCING DEMONSTRATION for counties converting to Managed Care Completion of this form is voluntary. Failure to complete will mean that the individual cannot participate in the rebalancing demonstration. Name Participant Medicaid ID Number I have been informed that The Money Foll.

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