To apply for a position with ConnectHealth, Inc., please follow the instructions below:

1. Print the Application Checklist

2. Complete the Uniform Application either by completing the fillable Word format document and then printing or by printing the .pdf form and submitting it.

3. Print the additional forms and submit all documents listed on the checklist by mailing them to the address printed below.  You may submit the documents by email or fax but must ALSO followup by mailing the originals. 

4. WE MUST RECEIVE ALL ORIGINAL DOCUMENTS WITH SIGNATURES BY MAIL.

5. Print and Mail to ConnectHealth, Inc:

   ConnectHealth, Inc
   6887 South Lake Avenue
   PO Box 266
   Lake Nebagamon, WI 54849

• Application Checklist (Word)(PDF)

• Uniform Application - Minnesota (Word)(PDF)

• Subcontractor Application (Word)(PDF)

• Wapiti Life Support Questionnaire (Word)(PDF)

• W-9 Form (PDF)

• Direct Deposit Form (PDF)

• 855i signature page (PDF)

• 855r signature page (PDF)