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DEPARTMENT OF HEALTH SERVICES×STATE OF WISCONSIN Division of Public Health F00695 (07/2016) CONNECTIONS TO COMMUNITY LIVING NONMDS REFERRAL AND TRACKING This form is to be used to record, for data
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How to fill out connections to community living

01
Step 1: Research and identify community living options available in your area.
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Step 2: Contact the community living provider or organization to inquire about the application process.
03
Step 3: Gather all necessary documents and information required for the application.
04
Step 4: Fill out the application form carefully, ensuring all fields are completed accurately.
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Step 5: Submit the completed application form along with any supporting documents.
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Step 6: Follow up with the community living provider to confirm receipt of your application.
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Step 7: Wait for the provider to review your application and make a decision.
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Step 8: If approved, arrange a time to meet with the provider to discuss further details and move forward with the process.
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Step 9: If denied, inquire about the reason for the denial and explore alternative options or appeal if applicable.
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Step 10: Once accepted, complete any additional paperwork or requirements as directed by the provider.
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Step 11: Prepare for the transition to community living by packing necessary belongings and making necessary arrangements.
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Step 12: Move into the community living setting and familiarize yourself with the facilities and services available.

Who needs connections to community living?

01
Individuals who require additional support in daily living activities.
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Elderly individuals who may benefit from a supportive living environment.
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People with disabilities who seek a community-based support system.
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Individuals with mental health conditions who would benefit from residing in a community living setting.
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Anyone who wishes to be part of a close-knit community and access various communal resources.

What is CONNECTIONS TO COMMUNITY LIVING NON-MDS REFERRAL AND TRACKING Form?

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Connections to community living is a form that individuals must submit in order to report any relationships or connections they have to the community they live in.
Any individual who has relationships or connections to the community they live in is required to file connections to community living.
Connections to community living can be filled out by providing detailed information about any relationships or connections an individual has to the community they live in.
The purpose of connections to community living is to ensure transparency and accountability by disclosing any potential conflicts of interest or biases that may exist.
Information such as the nature of relationships or connections, the extent of involvement in community activities, and any potential conflicts of interest must be reported on connections to community living.
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