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Welcome  » May 26, 2024 2:59 AM
  • Multi-factor authentication (MFA) is now required for the secure ForwardHealth Portal. Providers are encouraged to refer to the ForwardHealth Multi-Factor Authorization Instruction Sheet for help setting up MFA preferences.
    Providers may contact their Portal account administrator or call the ForwardHealth Portal Help Desk at 866-908-1363. Note: This is a project-specific announcement and is not related to the Change Healthcare disruption.
IRIS Forms List

IRIS Forms List

Category Form Number Title Direct Link to Form
BA/OTE F-01205B IRIS Participant Education: Budget Amendments www.dhs.wisconsin.gov/library/f-01205b.htm
BA/OTE F-01205C IRIS Participant Education: One-Time Expense Requests www.dhs.wisconsin.gov/library/f-01205c.htm
BA/OTE F-01206 IRIS One-Time Expense Request www.dhs.wisconsin.gov/forms/f0/f01206.docx
BA/OTE F-01206A IRIS One-Time Expense Vendor Bid Comparison www.dhs.wisconsin.gov/forms/f0/f01206a.docx
BA/OTE F-01206B IRIS One-Time Expense Request — Ramp www.dhs.wisconsin.gov/forms/f0/f01206b.docx
BA/OTE F-01210 IRIS Budget Amendment Request www.dhs.wisconsin.gov/forms/f0/f01210.docx
BA/OTE F-01210A IRIS Budget Amendment Provider Quote Comparison www.dhs.wisconsin.gov/forms/f0/f01210a.docx
BA/OTE F-01210B IRIS Budget Amendment Annual Verification (BAAV) Request www.dhs.wisconsin.gov/forms/f01210b.docx
BA/OTE F-01213 Accessibility Assessment Request www.dhs.wisconsin.gov/forms/f0/f01213.docx
Background Check F-01246 Background Information Disclosure Addendum — IRIS www.dhs.wisconsin.gov/forms/f0/f01246.docx
Background Check F-01352 Background Check Appeal Request — IRIS Program www.dhs.wisconsin.gov/library/f-01352.htm
Contractor Oversight F-02432 IRIS Program HIPAA Breach and Unauthorized Disclosure Reporting www.dhs.wisconsin.gov/forms/f02432.docx
Enrollment and Disenrollment F-00075 IRIS Authorization www.dhs.wisconsin.gov/library/f-00075.htm
Enrollment and Disenrollment F-01309 IRIS Program Orientation and Enrollment Checklist www.dhs.wisconsin.gov/library/f-01309.htm
Enrollment and Disenrollment F-01319 IRIS Involuntary Disenrollment Request www.dhs.wisconsin.gov/forms/f0/f01319.docx
Enrollment and Disenrollment F-01319B IRIS Denial of Enrollment Request www.dhs.wisconsin.gov/forms/f01319b.docx
Fiscal Reporting F-02021 IRIS — Certified Public Accountant (CPA) Audit Checklist www.dhs.wisconsin.gov/forms/f02021.docx
Fiscal Reporting F-02047 IRIS Financial Reporting Template www.dhs.wisconsin.gov/forms/f02047.xlsx
IRIS Quality F-01200 IRIS Program Cost Share Repayment Agreement www.dhs.wisconsin.gov/forms/f0/f01200.docx
IRIS Quality F-01212 Grievance — IRIS Program www.dhs.wisconsin.gov/forms/f0/f01212.docx
IRIS Quality F-01261 Fraud Statement — IRIS Program www.dhs.wisconsin.gov/forms/f0/f01261.docx
IRIS Quality F-01310A IRIS Program Conflict of Interest Disclosure — Participant www.dhs.wisconsin.gov/forms/f0/f01310a.docx
IRIS Quality F-01314 IRIS Program Employment Checklist www.dhs.wisconsin.gov/forms/f0/f01314.docx
IRIS Quality F-01558 Risk Agreement — IRIS Program www.dhs.wisconsin.gov/forms/f0/f01558.docx
IRIS Quality F-01689 Participant-Hired Worker 40-Hour Health and Safety Assurance Exception Request — IRIS Program www.dhs.wisconsin.gov/forms/f01689.docx
IRIS Quality F-01947 IRIS Participant Education Manual: Acknowledgement www.dhs.wisconsin.gov/forms/f01947.docx
IRIS SDPC F-01205J IRIS Participant Education: Self-Directed Personal Care www.dhs.wisconsin.gov/library/f-01205j.htm
IRIS SDPC F-01258 IRIS Self-Directed Personal Care (SDPC) Disclosure Statement www.dhs.wisconsin.gov/forms/f0/f01258.docx
IRIS SDPC F-01319D IRIS Self-Directed Personal Care (SDPC) Involuntary Disenrollment Request www.dhs.wisconsin.gov/forms/f01319d.docx
IRIS SDPC F-01566 IRIS Self-Directed Personal Care (SDPC) — My Cares www.dhs.wisconsin.gov/forms/f01566.docx
Notice of Action F-00236B Request for a State Fair Hearing — IRIS www.dhs.wisconsin.gov/library/f-00236b.htm
Notice of Action F-01204 Notice of Action — IRIS Program www.dhs.wisconsin.gov/library/f-01204.htm
PHW/Provider F-01201 IRIS Participant-Hired Worker Set-Up www.dhs.wisconsin.gov/forms/f0/f01201.docx
PHW/Provider F-01201A IRIS Participant-Hired Worker Relationship Identification www.dhs.wisconsin.gov/forms/f0/f01201a.docx
PHW/Provider F-01201C IRIS Participant Employer/Participant-Hired Worker Agreement www.dhs.wisconsin.gov/forms/f0/f01201c.docx
PHW/Provider F-01203 IRIS Provider Education — Health and Safety — Incident Reporting www.dhs.wisconsin.gov/forms/f01203.docx
PHW/Provider F-01240 IRIS Critical Incident Reconciliation www.dhs.wisconsin.gov/forms/f0/f01240.docx
PHW/Provider F-01312 IRIS Provider Application www.dhs.wisconsin.gov/forms/f0/f01312.docx
Systems F-01578 Wisconsin Self-Directed IT System (WISITS) — Request for User Set Up www.dhs.wisconsin.gov/forms/f0/f01578.docx
Systems F-01578A IRIS SharePoint – Request for User Setup www.dhs.wisconsin.gov/forms/f0/f01578a.docx
Systems F-02488 IRIS Monthly Rate of Service (MROS) Discrepancy Resolution www.dhs.wisconsin.gov/forms/f02488.xlsx
Systems F-00476 CARES Automated Systems Access Request www.dhs.wisconsin.gov/library/f-00476.htm
Transfer F-01293D IRIS Fiscal Employer Agent (FEA) Transfer Checklist www.dhs.wisconsin.gov/forms/f01293d.docx
Transfer F-01569 IRIS Consultant Agency (ICA) Transfer Checklist www.dhs.wisconsin.gov/forms/f0/f01569.docx
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