Please tell us about changes to WWC contacts at your agency. Send an email to Kris.McCracken@state.co.us or Ivy.Hontz@state.co.us when you have completed this survey.

* Agency or Site name

WWC Coordinator

Is this person replacing the current staff member in this WWC role?

eCaST Coordinator

Is this person replacing the current staff member in this WWC role?

Agency Director

Is this person replacing the current staff member in this WWC role?

Contract Administrator

Is this person replacing the current staff member in this WWC role?

Signature Authority

Is this person replacing the current staff member in this WWC role?

Clinical Liaison

Is this person replacing the current staff member in this WWC role?

Fiscal Payment Coordinator

Is this person replacing the current staff member in this WWC role?

Fiscal Manager

Is this person replacing the current staff member in this WWC role?

Case Manager

Is this person replacing the current staff member in this WWC role?

Other WWC staff

Is this person replacing the current staff member in this WWC role?

T