Joining Care Wisconsin's Provider Network
If you are interested in becoming a Care Wisconsin network provider, please complete one of the application forms below.
General Provider Application: (368 KB) Complete this application if you provide long-term care services. (examples include: Residential Facilities, Adult Day Care Services, Lawn Care Services, Transportation, Supportive Home Care, Prevocational Services)
Healthcare Provider Application: (502 KB) Complete this application if you provide Medical or Health services. (examples include: Mental Health, Physician, Hospital, SNF, Home Health Care, DME, Physical/Occupational Therapy, ASC)
You may also fax to: 608-245-3844 – Attn: Contracting Specialists