UW Medical Foundation,Patient Resources,Social Work Services Quick Guide,Social Work Manual,Travel/Transportation,Medicaid Travel,Wisconsin
Bus Passes - UW Medical Foundation, Patient Resources, Social Work Services Quick Guide, Social Work Manual, Travel/Transportation, Medicaid Travel, Wisconsin
UWHC/UWMF Bus Pass for Unexpected Trip
MTM TRANSPORTATION REQUEST FORM
This form is for MEDICAL ASSISTANCE patients ONLY!
- Complete one MTM – UWHC/UWMF Bus Pass for Unexpected Trip form for EACH bus pass distributed.
- Fax completed form to: 1-866-686-7618.
- After faxing, write the bus pass number (found on the back on the bus pass) on the completed MTM form.
- Send the completed form to the Coordinated Care office – tube number 661 - along with the fax confirmation form.
It is very important that we keep track of these bus passes accurately! We get only a few at a time and we only receive replacements for the number of bus passes accounted for.