Thank you for your interest to enroll as a Corporation/Lead Facility for the Care for Yourself - WISEWOMAN Program, please review the Health Care Facility and Health Care Provider Guide prior to completing the documents below. Approval to enroll in the WISEWOMAN Program is limited and pre-authorization to enroll as a Corporation/Lead Facility is required.
The WISEWOMAN Cooperative Agreement is not effective until the document has been fully executed with signatures of both parties and received by the Corporation/Lead Facility. The fully executed agreement will be scanned and electronically sent back to the applicant.
To submit the required materials, please send them in an email to Gena.Hodges@idph.iowa.gov. The subject line should state “WW Enrollment” and the Corporation/Lead Facility name. For further questions, please contact Gena Hodges at Gena.Hodges@idph.iowa.gov or 515-281-4909.