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佛罗里达消费者直接关怀网络

FORMS

Forms available in Spanish have a 🌐 icon. To view translated versions of these forms, select Spanish from the top menu.
UnitedHealthcare Forms

Enrollment Packets

Participant Enrollment Forms
Participant Enrollment Packet 🌐
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Participant Enrollment Packet Instructions 🌐
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Direct Service Worker Enrollment Forms
Direct Service Worker Enrollment Packet 🌐
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Direct Service Worker Enrollment Packet Instructions 🌐
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Additional Forms and Information

Feedback Form
Feedback Form 🌐
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Participant Direction Option (PDO) Information
PDO Guidelines 🌐
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PDO Consent Form 🌐
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PDO Manual
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Payroll Related Forms
IVR Registration Form 🌐
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2026 Payroll Calendar 🌐
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2025 Payroll Calendar 🌐
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Pay Selection Form 🌐
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Wisely Pay Card 🌐
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I-9 Instructions 🌐
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W-4 Form
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W-2 Frequently Asked Questions
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Fingerprinting Procedures and Information
Fingerprinting Procedures 🌐
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Direct Service Worker Information Needed for Fingerprinting 🌐
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Representative Information Needed for Fingerprinting 🌐
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EVV Notification
EVV Notification to DSW
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EVV Notification Letter to Participant
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Molina Forms

Enrollment Packet

Participant Enrollment Forms
Participant Enrollment Packet 🌐
View More
Participant Enrollment Packet Instructions
View More
Direct Service Worker Enrollment Forms
Direct Service Worker Enrollment Packet 🌐
View More
Direct Service Worker Enrollment Packet Instructions 🌐
View More

Additional Forms and Information

Feedback Form
Feedback Form
View More
Participant Direction Option (PDO) Information
PDO Guidelines 🌐
View More
PDO Manual
View More
Payroll Related Forms
IVR Registration Form 🌐
View More
2026 Payroll Calendar 🌐
View More
2025 Payroll Calendar 🌐
View More
Pay Selection Form
View More
Wisely Pay Card 🌐
View More
I-9 Instructions 🌐
View More
W-4 Form
View More
W-2 Frequently Asked Questions
View More
Fingerprinting Procedures and Information
Fingerprinting Procedures
View More
Direct Service Worker Information Needed for Fingerprinting
View More
EVV Notification
EVV Notification
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