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Managed Care Staffers Forms
Please download the following forms, print them, and complete. You may mail them in or submit them at the time of your interview.

Managed Care Staffers application form (pdf document)
Dept of Justice employment verification form (pdf document)
Federal W-4 form (pdf document)
Illinois W-4 form (pdf document)

Mailing address:

Managed Care Staffers
2604 Dempster St. Suite 409
Park Ridge, IL 60068

2604 Dempster St. Suite 409
Park Ridge, IL 60068

phone: (847) 390-0370
fax: (847) 699-0399

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