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DEPARTMENT OF HEALTH SERVICES Division of Long Term Care F01312 (08/2016) STATE OF WISCONSIN IRIS PROVIDER APPLICATION INSTRUCTIONS: Completion of this form is not required through Wisconsin State
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What is iris provider application?
The iris provider application is an application for individuals or entities who provide services or products to clients in the healthcare industry.
Who is required to file iris provider application?
Any individual or entity who provides services or products to clients in the healthcare industry must file an iris provider application.
How to fill out iris provider application?
To fill out the iris provider application, individuals or entities must provide detailed information about the services or products they offer, their contact information, and any relevant licenses or certifications.
What is the purpose of iris provider application?
The purpose of the iris provider application is to ensure that individuals or entities providing services or products in the healthcare industry meet certain criteria and standards.
What information must be reported on iris provider application?
Information such as services or products offered, contact information, licenses or certifications, and any other relevant details must be reported on the iris provider application.
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