Michigan Medicaid Electronic Signature Agreement

This page contains copies of forms frequently used by Medicaid providers. Most forms are provided in PDF and Word 2000 formats, which are activated to fill them out. If you have problems with documents on this page, please email us to MSA-FORMS@michigan.gov There should be no problems with .docx if you use FireFox, Chrome, Safari or newer versions of Internet Explorer. Home Health Help Request for Authorization/Authorization . NOTE: A well-known problem has arisen when trying to open documents with a .docx extension in Internet Explorer 8. If a Word document attempts to download/open as a file .zip: Occupational Therapy – Physiotherapy – Sprachtherapie Request for prior authorization/authorization.

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