Forms | Lori Knapp Choice™ Self-Direction Support

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Forms

Enrollment

Participant Enrollment Packet

↘ Participant Enrollment Packet (SP)

Participant Information Packet

↘ Participant Information Packet (SP)

Direct Care Worker Enrollment Packet

↘ Direct Care Worker Enrollment Packet (SP)

Direct Care Worker Enrollment Packet - Fond du Lac County

Direct Care Worker Enrollment Packet - Kenosha County

Direct Care Worker Enrollment Packet - Menominee

Direct Care Worker Enrollment Packet - Other Counties CLTS

Direct Care Worker Enrollment Packet - Shawano County

Direct Care Worker Enrollment Packet - Winnebago ADRC

Direct Care Worker Enrollment Packet - Winnebago

Direct Care Worker Information Packet

↘ Direct Care Worker Information Packet (SP)

Form W-9

Live-In Worker Verification Form

Fiscal Conduit Vendor Packet

Self-Direction Basics for New Participants

Self-Direction Basics for New Participants (SP)

Enrollment Resources

Sample I-9

Sample 2678

Sample SS-4

IRS Signature Requirements

Who To Call Template

Blank Job Description Template

Job Candidate Interview Form

Information Update

Information Change Form

Background Information Disclosure (BID)

Nonresident Employee's Withholding Reciprocity Declaration

Mileage Memo

Payroll Authorization

Verification of Information

Funding Sources

Funding Source Portal

Funding Source Portal - Winnebago

Payroll

2026 Payroll Schedule

Timesheet

Participant Check Request

Mileage Log

Web Entry Instructions

VIDEO | Web Entry for the Direct Care Worker - Entering Hours

VIDEO | Web Entry for the Participant - Approving Hours

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