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Use this form to order additional copies of the Prenatal Care Coordination Services Handbook. You may also use this form to order three-ring binder to hold your handbook(s).
| Handbook Name | Quantity | Amount | Total |
|---|---|---|---|
| Prenatal Care Coordination Services Handbook | $4.00 | ||
| Wisconsin Medicaid Binder | $5.00 | ||
| Subtotal | $_________ | ||
| 5% Sales Tax | $_________ | ||
| 1/2 % County Sales Tax (if applicable) | $_________ | ||
| Total Enclosed | $_________ | ||
If applicable, tax exempt number: _________________________________
Contact person: ______________________________________
Company or organization: _______________________________
Address: ____________________________________________
City/State/ZIP: _______________________________________
Send this information and a check or money order (made payable to EDS) for the full amount, including sales tax, to:
Wisconsin Medicaid
Provider Maintenance
6406 Bridge Road
Madison, WI 53784-0006
|
Download Medicaid and BadgerCare handbooks from the Web Wisconsin Medicaid and BadgerCare handbooks are also available on the Internet. To download this handbook or its sections free of charge from the World Wide Web, visit the Handbooks area of the Provider Publications section of the Medicaid Web site at dhs.wisconsin.gov/medicaid/. |
Ordering Wisconsin Statutes & Wisconsin Administrative Code
You may purchase a copy of HFS 101-108, Wis. Admin. Code, and Wisconsin Statutes from the Document Sales address or telephone number below.
Write:
Document Salesor call:
(608) 266-3358