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Construction/Remodeling Plan Review for Health Care Facilities: Forms and Checklists

Plan submittals must be submitted to the Office of Plan Review and Inspection (OPRI) as PDF files. Submittals should include the following:

  • Construction plans, with the seal and signature of the designer
  • Completed Plan Approval Application
  • A copy of the plan submittal fees checks

Send plan submittals to

Mail the following to the plan intake coordinator at the Wisconsin Department of Health Services (DHS):

  • Payment for the plan submittal fees (in the form of a check)
  • A copy of the completed Plan Approval Application
DHS Division of Quality Assurance
ATTN: Plan Intake Coordinator
819 N. 6th St., Room 609B
Milwaukee, WI 53203-1606

This will ensure the plan intake coordinator matches payment to the correct construction project. Once you pay the fees, we will process the plans and send you an email.

Incomplete applications

Incomplete applications will not be processed. Applications are incomplete if they:

  • Omit items (plans, application form, money).
  • Don't include a signed/sealed plan.
  • Have a missing or incorrect fee.
  • Have missing or incorrect information on the application.

Submit health care facility plumbing plans to the Department of Safety and Professional Services (DSPS) for review.


Compliance statement and health care facility construction documentation checklist

Applicants must submit a Compliance Statement prior to OPRI final inspection. Questions about a final inspection should be directed to your Department of Quality Assurance (DQA) inspector.

  • Compliance Statement, F-62495 (Word) - Required before a new build or addition is occupied. It is also required before final occupancy is granted for an existing building with changes.

The Health Care Facility Construction Documentation Checklist includes common items reviewed during a health care construction inspection.

Petition for variance

Variances allow applicants to use a different method to meet building code requirements. To request a variance, complete and submit the Petition for Building Code Variance, F-62537 (Word).

Fire reporting

All fires in a licensed facility in Wisconsin must be reported to DHS within 72 hours. To report a fire, complete and submit the Health Care Facility Fire Report, F-62500.

For questions regarding fire reporting, contact the DQA Fire Authority:

See DQA numbered memo 23-002 (PDF) for more information.

Contact us

DHS Division of Quality Assurance
ATTN: Plan Intake Coordinator
819 N. 6th St., Room 609B
Milwaukee, WI 53203-1606

If you have questions regarding completing forms, call the plan intake coordinator at 414-227-4085.


Last revised May 23, 2024