Department of Health Services Logo


Wisconsin Department of Health Services

If You Have Complaints about Wisconsin Health Care

Information about Division of Quality Assurance (DQA)

Provider Types Regulated by DQA

DQA Listservs

Provider Search

Provider Training

DQA Numbered Memos

DHS Forms

Remodeling of Health Care Facilities

WI Nurse Aide Training and Registry Info

Caregiver Program/ Background Checks

WI Adult Programs Caregiver Misconduct Registry

Corporate Guardianships - Forms

Introduction | Rules & Regulations | Forms | Providers | Contacts

Questions concerning Wisconsin corporate guardianships, call or E-mail Dinh Tran, (608) 266-6646.

F-60820: Corporate Guardian Status Application (Word, 150 KB)  Note: You can print the completed document but you cannot save it.

You must also file Articles of Incorporation (Nonstock Corporation) (exit DHS, PDF, 87 KB) with the Wisconsin Department of Financial Institutions (exit DHS) before submitting form F-60820.

The Caregiver Law, under s.50.065, Stats., requires two types of caregiver background checks:

  1. Those completed by employers on their employees and contractors.
  2. Those completed by the Division of Quality Assurance (DQA) on license applicants/license holders and/or some principal officers of DQA-regulated facilities.

Beginning April 2, 2013, the Division of Quality Assurance began an automated Caregiver Background Check Process - A caregiver background check (CBC) is completed on all new and/or existing Guardianship Program Managers.

Review information for Licensee Applicants/License Holder Background Checks found on the Caregiver Background Check Process web page for the completion of the Background Information Disclosure (BID) form and Appendix. Complete either the Online Caregiver Background Check (CBC) process or submit a paper application.


Last Updated: August 07, 2014