Form F-13164 Wisconsin Seniorcare HIPAA Privacy Alternate Communication Request - Wisconsin

Form F-13164 Wisconsin Seniorcare HIPAA Privacy Alternate Communication Request - Wisconsin

What Is Form F-13164?

This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form F-13164?
A: Form F-13164 is the Wisconsin Seniorcare HIPAA Privacy Alternate Communication Request form.

Q: What is the purpose of Form F-13164?
A: The purpose of Form F-13164 is to request alternative communication methods for the Wisconsin Seniorcare program.

Q: What is the Wisconsin Seniorcare program?
A: The Wisconsin Seniorcare program is a prescription drug assistance program for Wisconsin residents who are 65 years or older.

Q: What are alternate communication methods?
A: Alternate communication methods are different ways of receiving program-related communications, such as mail or phone calls.

Q: Who can use Form F-13164?
A: Wisconsin Seniorcare program participants who need alternative communication methods can use Form F-13164.

Q: Is there a deadline for submitting Form F-13164?
A: There is no specific deadline for submitting Form F-13164, but it should be submitted as soon as the need for alternative communication methods arises.

Q: Can I make changes to my alternate communication preferences?
A: Yes, you can make changes to your alternate communication preferences by submitting a new Form F-13164 to the Wisconsin Seniorcare program office.

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Form Details:

  • Released on July 1, 2008;
  • The latest edition provided by the Wisconsin Department of Health Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form F-13164 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.

Download Form F-13164 Wisconsin Seniorcare HIPAA Privacy Alternate Communication Request - Wisconsin

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