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Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions

Assigned Number Title Release Date File Type Language Available to Order
F-00221 Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions 02/22/2024 Word English No
F-00221 Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions (DocuSign) 02/22/2024 HTML English No
F-00221LP Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions (Large Print) 02/22/2024 Word English No
F-00221AR Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Arabic 02/22/2024 PDF Arabic No
F-00221CM Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Chinese (Mandarin) 02/22/2024 Word Chinese Mandarin No
F-00221H Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Hmong 02/22/2024 Word Hmong No
F-00221L Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Laotian 02/22/2024 Word Laotian No
F-00221R Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Russian 02/22/2024 Word Russian No
F-00221SE Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Serbo-Croatian 02/22/2024 Word Serbian (Serbo-Croatian) No
F-00221SO Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Somali 02/22/2024 Word Somali No
F-00221S Family Care / IRIS Member Requested Disenrollment or Transfer and Instructions, Spanish 02/22/2024 Word Spanish No
Last revised April 25, 2024