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Waksman WIN: Wellness Inclusion Nursing Program University of Wisconsin Madison 122 E. Olin Ave, Ste.100 Madison, WI 53713 Phone: (608) 265-9440 Fax: (608) 263-4681 Waksman WIN Referral Request Form
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How to fill out Waisman Win Wellness Inclusion:

01
Gather all necessary information: Before filling out the Waisman Win Wellness Inclusion form, make sure you have all the required information readily available. This may include personal details, medical history, and any relevant documents.
02
Read the instructions carefully: Familiarize yourself with the instructions provided on the form. It is crucial to understand the specific requirements and guidelines for completing the document accurately.
03
Provide personal information: Begin by filling out the sections that ask for personal information. This may include your full name, address, contact details, and identification number, among other relevant details. Make sure to provide accurate and up-to-date information.
04
Include medical history: One important aspect of the Waisman Win Wellness Inclusion form is the medical history section. Fill out this part by providing details of any existing medical conditions, allergies, and medications you are currently taking. Mention any relevant surgeries or treatments you have undergone in the past.
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Answer the inclusion questionnaire: The form may include a section with a series of questions regarding wellness inclusion. Answer each question honestly and to the best of your knowledge. These questions aim to assess your current state of wellness and determine if you meet the criteria for wellness inclusion.
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Attach necessary documents: If the Waisman Win Wellness Inclusion form requires supporting documentation, ensure you gather and attach them appropriately. This may include medical reports, physician statements, or any other relevant paperwork requested.
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Review and double-check: Before submitting the completed form, take the time to review all the information you have provided. Double-check for any mistakes, missing information, or inconsistencies. It is essential to ensure the form is accurate and complete before submission.

Who needs Waisman Win Wellness Inclusion:

01
Individuals with disabilities: The Waisman Win Wellness Inclusion is designed for individuals with disabilities. It aims to promote their access to wellness programs and services that cater specifically to their needs.
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Caregivers and guardians: Caregivers and guardians of individuals with disabilities may also need to be familiar with the Waisman Win Wellness Inclusion. They may assist in filling out the form on behalf of the person they care for.
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Healthcare professionals: Healthcare professionals who work with individuals with disabilities should have knowledge of the Waisman Win Wellness Inclusion. They may help guide their patients or clients through the process and provide any necessary medical information.
Note: The specific requirements for who needs the Waisman Win Wellness Inclusion may vary depending on the organization or program implementing it. It is advisable to consult the relevant authorities or individuals responsible for administering the wellness inclusion program to determine eligibility.
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Waisman Win Wellness Inclusion is a program designed to promote wellness and inclusion in the workplace.
All employers are required to file Waisman Win Wellness Inclusion.
To fill out Waisman Win Wellness Inclusion, employers need to provide information about their wellness and inclusion initiatives in the workplace.
The purpose of Waisman Win Wellness Inclusion is to encourage employers to create a healthy and inclusive work environment.
Employers must report on their wellness programs, initiatives to promote diversity and inclusion, and any actions taken to address barriers to wellness and inclusion.
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