Michigan Medicaid Provider Electronic Signature Agreement

This page contains copies of forms frequently used by Medicaid providers. Most forms are provided in PDF and Word 2000 format. If you have problems with documents on this page, please email us at MSA-FORMS@michigan.gov There should be no problem with .docx when using FireFox, Chrome, Safari or recent versions of Internet Explorer. Occupational therapy – Physiotherapy – Language therapy Request / Prior authorization. NOTE: There is a well-known issue when opening documents with an extension .docx in Internet Explorer 8. If a Word document tries to download/open as a file .zip: Home Health Aide Prior Approval Request/Authorization. . . .