FORMS, PUBLICATIONS AND POSTERS

There are FREE posters available. The web page: Ordering Paper Forms and Publications From the Forms Center has information on how to order. You may also contact Lois Mulder with questions about ordering posters and forms at the email: DHSFMDDEPDE@dhs.wisconsin.gov

If a publication does not have a link to it from this page then please refer to the page above for ordering information.

If no language is listed then the publication is only available in English.

A program may create a personalized brochure by highlighting and copying the text from the HTML version of the applicable brochure into one with the program’s name, logo, or other identifying information. If this is done, all of the text in the applicable brochure must be included in the information provided to clients about their rights. The PDF version has a fillable space to insert your client rights contact information.

DHS 57 and Residents of Group Foster Homes:

In accordance with DCF 57  (exit DHS, PDF), effective January 1, 2006, residents of Group Foster Homes have the same client rights as individuals receiving services for mental illness, developmental disabilities or substance abuse. Specific rights materials for Group Foster Homes are being developed. When they are completed, they will be available through this site. Until such materials are developed, operators of Group Foster Homes can use the Client Rights materials available below. Residents can be informed that they have these rights, even though the materials may not specifically mention Group Foster Homes. We recommend using the red poster P-23127, brochure P-20195A. Teen Rights P-20470, only applies to teens receiving inpatient mental health treatment, so it should not be used for Group Foster Homes.

• P-23126 Clients Rights for Community Services (blue poster-Out patient)
• P-23127 Clients Rights for Inpatient and Residential Services (red poster)

To order the posters above; please visit the DHS web page: How to Electronically Order Forms and Publications.

Wisconsin Administrative Codes, Department of Health Services.

• DHS 92, Confidentiality of Treatment Records (exit DHS; PDF)
• DHS 94, Patient Rights (exit DHS, PDF)

P-20195A Client Rights and the Grievance Resolution Procedure for In-Patient or Residential Services

• P-20195A English (8½ by 14) (PDF, 24 KB)
• P-20195AWP English (8½ by 11) (PDF, 17 KB)
  Note: This has the same text as the version above.
• P-20195AH Hmong (HTML)
• P-20195AH Hmong (PDF, 19 KB)
• P-20195AS Spanish (HTML)
• P-20195AS Spanish (PDF, 41 KB)

P-20142 Client Rights and the Grievance Procedure For the Conditional Release Program

• P-20142 English (8½ by 14) (PDF, 191 KB)
• P-20142AS Spanish (8½ by 11) (PDF, 29 KB)

P-23112 Client Rights and the Grievance Procedure for Community Services*
*For Clients Receiving Services in Wisconsin for Mental Illness, Alcohol or Other Drug Abuse, or Developmental Disabilities
*The term Community Services refers to all services provided in non-inpatient and non-residential settings.

• P-23112 English (HTML)
• P-23112 English (PDF, 20 KB)
• P-23112H Hmong (HTML)
• P-23112H Hmong (PDF, 20 KB)
• P-23112S Spanish (HTML)
• P-23112S Spanish (PDF, 43 KB)

Also available are:

• F-20009 Complaint Report (PDF, 12KB) for use in state-operated Mental Health Institutes or Centers for the Developmentally Disabled.

P-20330 Rights of Individuals Receiving Services from State Centers for the Developmentally Disabled
Under Federal Law and DHS 94, Wisconsin Administrative Code

• P-20330 English (PDF, 28KB)
• P-20330S Spanish (PDF, 32KB)

P-20470 in English, Hmong and Spanish.

• P-20470 Rights of Children and Adolescent Patients in Inpatient Mental Health Facilities (8½ by 14) English (PDF, 166KB)
• P-20470A Rights of Minors in Inpatient Community Mental Health Facilities (8½ by 14) English (PDF, 166KB)
• P-20470B Rights of Children and Adolescents in Outpatient Mental Health Treatment English (PDF, 166KB)
• P-20470BH Rights of Children and Adolescents in Outpatient Mental Health Treatment Hmong (PDF, 155KB)
• P-20470BS Rights of Children and Adolescents in Outpatient Mental Health Treatment Spanish (PDF, 155KB)

P-20377 in English and Spanish, for patients in State-Operated Facilities.

• P-20377 Your Rights and the Grievance Resolution Process. English
  To order the form above; please visit the DHS web page: How to Electronically Order Forms and Publications.
  P-20377A Chapter 980, Wisconsin Statutes, Patients Rights Exceptions Supplement (WORD, 36KB)
• P-20377S Your Rights and the Grievance Resolution Process Spanish (PDF, 130 KB)
• P-20377AS Chapter 980 Addendum, Your Rights and the Grievance Resolution Process Spanish (WORD, 38KB)

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Last Updated: December 22, 2011