Wisconsin law allows ETF to release personal information to a third party if the member has first provided ETF with a valid written authorization. Use this form to authorize the release of non-medical information.
• Froedtert Health • Children’s Hospital of Wisconsin - with locations in Milwaukee, Green Bay and Neenah • ThedaCare • Ascension Wisconsin • Bellin Health • Prevea Health • SSM Health
If you retired due to a disability, you may be eligible for Medicare benefits. Medicare eligibility related to disability is available to persons who have received Social Security disability benefits for at least 24 months, who have End Stage Renal Disease (ESRD), or Lou Gehrig’s Disease (ALS).
