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DEPARTMENT OF HEALTH SERVICES STATE OF WISCONSIN Division of Quality AssuranceF62645C (05/2020)DRUG REPOSITORY PROGRAM DESTRUCTION RECORD Completion of this form meets the requirements of Wisconsin
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How to fill out wisconsin community-based care and

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Start by obtaining the Wisconsin community-based care form. You can download it from the official website or get a physical copy from a local community center.
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Begin by providing personal information such as your name, address, contact details, and social security number.
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Fill out the sections related to your current living situation and any medical conditions or disabilities you may have.
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Provide details about your income, including any government assistance programs you are currently receiving.
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If applicable, provide information about your spouse or any dependents who are also in need of community-based care.
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Sign and date the form at the designated spaces.
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Who needs wisconsin community-based care and?

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Wisconsin community-based care is designed for individuals who are in need of long-term care services and supports.
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This includes individuals with physical or cognitive disabilities, older adults with chronic conditions, and individuals with mental health needs.
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People who require assistance with daily activities such as bathing, dressing, meal preparation, and medication management can benefit from this program.
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Family caregivers who are providing care for their loved ones may also seek community-based care to alleviate the caregiving burden and ensure the well-being of the care recipient.
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Wisconsin community-based care and is a program that provides support and services to individuals who need assistance with daily activities in their own homes or community.
Individuals who are receiving services through the Wisconsin community-based care program are required to file a report.
To fill out the Wisconsin community-based care report, individuals must provide information about their daily activities and the specific services they are receiving.
The purpose of Wisconsin community-based care is to promote independence and well-being for individuals who require assistance with daily activities.
Information such as the type of services received, any changes in health status, and overall satisfaction with the program must be reported on the Wisconsin community-based care form.
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