Wisconsin DHS Casualty Recovery Relevant Forms

Forms

HIPAA Release Form

1.  PDF Format
2.  Word Format

Subrogation Recovery Information Form

Contact Information

Wisconsin Casualty Recovery
HMS Case Management - WI
5615 High Point Drive
Irving, TX 75038-9984
Toll Free:  (877) 391-7471
Fax:  (469) 359-4319
Email:  wicasualty@gainwelltechnologies.com