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DEPARTMENT OF HEALTH SERVICES Division of Medicaid Services F01201 (09/2020)STATE OF WISCONSINITES PARTICIPANTHIRED WORKER SETUP INSTRUCTIONS:Completion of this form is not required through Wisconsin
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This packet includes all necessary documents for hiring a participant worker.
Employers who are hiring participant workers are required to file this packet.
The packet should be filled out with accurate information about the participant worker being hired.
The purpose is to properly document the hiring of a participant worker and ensure compliance with regulations.
Information such as the worker's personal details, job role, and relevant documentation must be reported.
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