Forms for Participants and Providers

Forms for Participants and Providers

Information for Participants and Families

Participant Rights and Responsibilities:
https://www.dhs.wisconsin.gov/forms/f20985.pdf

Other languages: 
https://www.dhs.wisconsin.gov/library/collection/f-20985 

Deciding Together: 
https://www.dhs.wisconsin.gov/publications/p02246.pdf

Other languages: 
https://www.dhs.wisconsin.gov/library/collection/p-02246

Family Guide to Incident Reporting: 
https://www.dhs.wisconsin.gov/publications/p0/p00069a.pdf 

CLTS Services at a Glance: 
https://www.dhs.wisconsin.gov/publications/p02570.pdf 

Parental Fee – Brochure:
https://www.dhs.wisconsin.gov/clts/costs.htm

Parental Fee Information:
https://www.dhs.wisconsin.gov/library/collection/p-03342

 

CLTS Provider Registry

For any service CLTS would fund, it is a requirement for the CLTS program that providers are listed on the CLTS Provider Registry and accept payments from the 3rd Party Payer for CLTS:

View this Link for statewide CLTS Provider Registry: https://cltsproviderdirectory.wi.gov/s/

 

Information for Providers of CLTS:
https://www.dhs.wisconsin.gov/clts/provider-home.htm 

View this link for the CLTS Manual:
https://www.dhs.wisconsin.gov/publications/p02256.pdf

View this Link for CLTS Provider Resources:
https://www.dhs.wisconsin.gov/clts/provider-home.htm

View this Link for 3rd Party Payer Resources:
https://www.wpshealth.com/resources/provider-resources/clts.shtml

CLTS Rate Schedule:
https://www.dhs.wisconsin.gov/library/collection/p-02184 

CLTS Crosswalk:
https://www.dhs.wisconsin.gov/library/collection/p-02283 

Providers who are interested in learning more can contact our Provider Relations at: JGohde@winnebagocountywi.gov