Community-Based Residential Facilities: Forms

For questions regarding community based residential facilities, you may contact the Bureau of Assisted Living, Division of Quality Assurance.

All fires in a licensed health or residential care facility in Wisconsin must be reported to the Department of Health Services within 72 hours (check specific rule requirements).

  • You may use the Fire Report, F-62500 (Word) and fax to 608-267-0352. Questions about this process may be directed to the "Fire Authority" at 608-266-8016. Refer to DQA memo 17-003 (PDF) for additional information.

Construction/Remodeling of Health Care Facilities - Plan Review Requirements (including forms)

Wisconsin Client Rights and Grievance Procedure - includes forms

Last Revised: April 3, 2018