Common Contracts
1 similar Department of Health Services contracts
IRIS PARTICIPANT EMPLOYER / PARTICIPANT- HIRED WORKER AGREEMENTDepartment of Health Services • April 11th, 2014
INSTRUCTIONS: Completion of this form is not required through Wisconsin State Statute; however, completion of this form is an IRIS Program requirement. Both the participant-hired worker and the participant employer must sign and date the bottom in order to be considered complete. Participant-hired worker may not begin working for participant employer until they have received a mailed start date letter. Personally identifiable information on this form is collected to verify that the application is complete, and will be used only for this purpose. Completed forms should be submitted to the participant’s Fiscal Employer Agent.
