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How to fill out the 2005 Provider Application - Wisconsin Department Of Children And ... - Dcf Wisconsin online
Filling out the 2005 Provider Application is a crucial step for service providers seeking inclusion in the Milwaukee Wisconsin Works Preferred Provider Registry. This guide will walk you through the process in a clear and instructive manner, ensuring that you can successfully complete the application online.
Follow the steps to complete your Provider Application online.
- Press the ‘Get Form’ button to access the application form for editing.
- Begin by entering your agency information. Include your agency name, establishment date, and the agency director's contact information. Ensure accuracy as this data is essential for communication.
- Complete the 'Minority or Disadvantaged Vendor' section, where you will check off your organization’s status regarding minority ownership and control.
- Fill in the site information for each location where services are provided. This includes the site name, address, contact person, and facility accessibility features.
- Carefully respond to the provider profile section. Provide a detailed description of your agency, including the services offered and community connections.
- Complete the response items for each service type your agency offers, such as AODA, mental health assessments, domestic violence services, and vocational evaluations. Ensure to attach any relevant certifications.
- Include proof of insurance as part of your application attachments, ensuring it meets the specified coverage requirements.
- Finalize your application by signing it. Ensure that the authorized director or their designee has signed and dated the application.
- Submit the completed application alongside three copies to the designated mailing address before the deadline.
Complete the 2005 Provider Application online today to ensure your agency can provide essential services in the Milwaukee community.
Am I Eligible? When you apply for Wisconsin Shares your income must be at or below 185% of the Federal Poverty Level (FPL) for your group size. Your eligibility may continue until your income reaches 85% of the State Median Income (SMI). Parent's Frequently Asked Questions about Wisconsin Shares wisconsin.gov https://dcf.wisconsin.gov › wishares › parents › parentfaq wisconsin.gov https://dcf.wisconsin.gov › wishares › parents › parentfaq
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