IRIS Forms
Learn more about the IRIS (Include, Respect, I Self-Direct) program. Find the forms and documents you need on this page.
- Orientation and Enrollment Checklist, F-01309 (Word)
- Medical and Remedial Expense Checklist, F-00295 (Word)
- Accessibility Assessment Request, F-01213 (Word)
- Conflict of Interest Disclosure—Participant, F-01310A (Word)
- Risk Agreement—IRIS Program, F-01558 (Word)
- Participant-Hired Worker 40-Hour Health and Safety Assurance Exception Request, F-01689 (Word)
- Cost Share Repayment Agreement, F-01200 (Word)
- IRIS Consultant Agency (ICA) Transfer Checklist, F-01569 (Word)
- Home and Community-Based Settings (HCBS) Rule Modification, F-03392 (Word)
- Budget Amendment Request, F-01210 (Word)
- Budget Amendment Provider Quote Comparison, F-01210A (Word)
- Budget Amendment Annual Verification (BAAV) Request, F-01210B (Word)
- One-Time Expense Request, F-01206 (Word)
- One-Time Expense Vendor Bid Comparison, F-01206A (Word)
- One-Time Expense Request—Ramp, F-01206B (Word)
- Participant-Hired Worker Employee Set-Up, F-01201 (Word)
- IRIS Participant-Hired Worker Relationship Identification, F-01201A (Word)
- IRIS Participant Employer/Participant—Hired Worker Agreement, F-01201C (Word)
- Application for Employer Identification Number, FSS-4
(PDF) - Employer/Payer Appointment of Agent, F2678
(PDF) - Form W-4
(PDF) - Employment Eligibility Verification, I-9
(PDF)
- IRIS Certification Acknowledgement, F-01209 (Word)
- IRIS Critical Incident Reconciliation, F-01240 (Word)
- IRIS Involuntary Disenrollment Request, F-01319 (Word)
- IRIS Denial of Enrollment Request, F-01319B (Word)
- IRIS HIPAA Breach and Unauthorized Disclosure Reporting, F-02432 (Word)
- IRIS Self-Directed Personal Care (SDPC) Involuntary Disenrollment Request, F-01319D (Word)
- IRIS Program Conflict of Interest Disclosure—Provider, F-01310 (Word)
- IRIS Program Employment Checklist, F-01314 (Word)
- Wisconsin Self-Directed IT System (WISITS)—Request for User Setup, F-01578 (Word)
- IRIS Sharepoint Request for User Setup, F-01578A (Word)
- IRIS Consultant Agency Transfer Checklist, F-01569 (Word)