Individual Service Plan Packet

Below are links to documents and webpages to assist with the Individual Service Plan Packet. Some are examples to aid you in your application and some are templates for your use. Don't forget to review the information on Timely Filing before you begin.

File Your Service Plan Electronically (Web page)

Individual Service Plan Packet Checklist (PDF, 18kb)

Sample CRS Cover Letter (PDF, 18kb)

Individual Service Plan (Web page)

Service Definitions (Web page)

Independent Assessment Template (Web page)

Crisis Back-Up Plan Example (MS Word, 25kb)

Medicaid Member Eligibility Information for Community Recovery Service: DHS Form F-00296

 Proof of Medicaid Eligibility (PDF, 317kb)
(screen-print from https://www.forwardhealth.wi.gov/WIPortal )

AFH, RCAC, or CBRF Rate Documents (Webpage)

Last Revised: May 05, 2011