Common Contracts
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IRIS Participant Hired Worker Paperwork ChecklistMarch 30th, 2016
IRIS Participant Hired Worker Information Form – optional Form F-01246 Background Information Disclosure Addendum-IRIS Form F-82064 Background Information Disclosure (BID) – three pages GT Independence Criminal Record Check Consent Form Form F-01201A IRIS Participant-Hired Worker Relationship Identification Form F-00180B Wisconsin Medicaid Program Provider Agreement and Acknowledgement of Terms of Participation – two pages Form F-01201 IRIS Participant-Hired Worker Set-Up Form F-01201C IRIS Participant Employer/Participant Hired-Worker Agreement – two pages Form F-01701 IRIS Participant-Hired Worker Education: Participant-Hired Worker 40-Hour Health andSafety Assurance Form F-01201B IRIS Supportive Home Care / Self-Directed Personal Care / Respite Care TrainingVerification – two pages Form W-4 (2016) Form WT-4 Employee’s Wisconsin Withholding Exemption Certificate/New Hire Reporting Form I-9 Employment Eligibility Verification – five pages Obtain copies of I-9 verification documents (i
