GO Passport


	Individual & Family Health Plans

	Member Materials

	State of Wisconsin Employees

	Dane County Employees

	Federal Employees

	BadgerCare Plus

	PPO Members

	Pharmacy Services for P+ Members

	GO-TO Account Instructions

	Connect with MyChart

	Appeal Process

	FAQs

	Wellness Programs

	GO-TO Healthy Choices

	Stay Healthy

	Manage Your Health Condition

	MobileNurse


	GO-TO: Health Plan Manager

	GO-TO Healthy Choices

	GO-TO Healthy Choices Employer Toolkit

	Administrative Manual & Forms

	Benefit Summaries

	Provider Network Service Area

	WorkWell Plus

	PlusNotes

	FAQs


	GO-TO Provider Reference Guide

	Provider Manual & Forms

	Pharmacy Services

	Population Health Management

	Care Guidelines

	Coverage & Regulatory Updates

	GO-TO for Providers


	Agent Service Center

	Benefit Summaries

	Forms: Large Group

	Forms: Small Group

	Forms: Individual/Family

	Forms: Medicare Supplement

	Provider Network Service Area


	Careers

	Our Community

	Get Out!

	Quality Commitment

	Making Sense of Health Care Reform

	Media Relations


	Careers

	Our Community

	Get Out!

		Receive GO! Event Notifications

	Quality Commitment

	Making Sense of Health Care Reform

	Media Relations

Your GO Passport

Child's Full Name
Address
City
State
Zip code
Daytime Phone
Child's Age
Parent/Guardian name
Parent/Guardian email (optional)
Parent/Guardian initials
^{The parent/guardian must enter their initials in the above box to indicate agreement to the following statements: I give permission for my child to receive a Physicians Plus GO Passport and program information. I understand that I am completely liable for any actions of this child during program participation. I release Physicians Plus Insurance Corporation (.sponsor.) and all other partners in the promotion and their directors, officers, employees and agents from responsibility and any liability for any injury, losses or damages of any kind incurred by my child or any other person as a result of participation in this program and acceptance and use of any prize. I understand that I am responsible for any federal, state or local taxes that may be associated with winning a prize. I certify that the information I have provided is correct and that I have not committed fraud or deception in giving my permission for the child to participate in the program or in claiming any prize.}