Get Wi Dhs F-00116 2010-2025

This guide provides step-by-step instructions on how to complete the Wisconsin Department of Health Services F-00116 form online. By following these instructions, you can ensure that all necessary information is accurately filled out and submitted appropriately.

Follow the steps to successfully complete the form.

1. Press the ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by checking the type of Registry access you require. Options include Screening Provider, Health Maintenance Organization (HMO), School, or Department of Health Services (DHS) Agent.
3. Fill in the 'Print Name of Organization' field with the official name of your organization.
4. In the 'Print Name of Site Administrator' field, enter the name of the designated representative responsible for the organization.
5. Ensure that the Site Administrator signs and dates the form in the designated area.
6. If there is a Main Contact different from the Site Administrator, provide their name, email address, phone number, and address.
7. The Main Contact, if applicable, must sign and date their section of the form.
8. Once all fields are completed, review the information for accuracy and completeness.
9. After verifying that the information is correct, save your changes, download a copy for your records, and print or share the form as needed.

Complete your documents online today to ensure timely and accurate submissions.