wisconsin – forms2019-11-19T23:04:01+00:00
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The following forms need to be completed by the participant so they can be set up as an employer through Outreach Health Services. This is needed for Outreach to provide payroll services to their hired workers (participant hired workers – PHW).

Please take the time to download, review and complete the Participant/Employer Packet and return the completed forms to Outreach Health Services.

You can email the completed packet to wisconsin@outreachhealth.com or fax it to 800-687-3121.

Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF

The following forms are used to enroll as a Participant’s Hired Worker (PHW). Please take the time to download, review and complete the Participant’s Hired Worker Packet and return the completed forms to Outreach Health Services. You can fax or mail the PHW packet using the following information:

Email: wisconsin@outreachhealth.com

Toll Free Fax: 800-687-3121

Mailing Address: Outreach Health Services of WI
204 3rd Ave Suite 110
P.O Box 945
Osceola WI 54020

It is very important that you complete these forms and return them to Outreach as quickly as possible.  You will not be paid for work time until these forms have been received and are processed by Outreach Health Services.

Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF

The following forms need to be completed by a vendor that is providing services to a Participant/Employer to receive payment.

Please take the time to download, review and complete the Vendor Packet and return the completed forms to Outreach Health Services. You can email the completed packet to wisconsin@outreachhealth.com or fax it to 800-687-3121.

Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF

The following forms are used by the Participant’s Hired Worker (PHW) to receive payment.  Timesheets must be submitted by fax, email, or the Outreach Member Portal before midnight on the due date listed on the Payroll Payment Schedule.

Toll Free Fax: 800-687-3121
Email: wisconsin@outreachhealth.com
Outreach Member Portal: www.outreachhealth.com/WI

Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF
Downloadable PDF