Outreach & Educational Documents Request Form

MDHHS has created materials for stakeholders to conduct outreach during the restart of Medicaid redeterminations. To assist the Department with tracking and reporting outreach efforts, materials must be requested through the linked request form. Stakeholders must request new materials each time a new outreach effort is initiated. Once the form is completed, the most recent version of the material will be emailed to the requestor.

Things to note:

• These documents are to be used for broad and general outreach.
• Stakeholders are only allowed to conduct outreach for the dates and regions indicated on the form.
• A new request should be submitted if material is to be used in a different county/timeframe then originally requested.
• The only allowed changes to documents is the addition of the organization’s logo on items with the “editable files” label.
• Medicaid Health Plans do not need to send these documents to their Contract Manager for approval prior to use.
• Please use an email address that is regularly monitored in case you are contacted.

Restart of Medicaid Redeterminations Outreach and Educational Documents Request Form