Residential Care Apartment Complexes: Forms
New online licensure and certification system for health and residential care providers
The Wisconsin Department of Health Services (DHS) Division of Quality Assurance (DQA) launched the DHS DQA Provider Portal, a new online system for licensure/certification, background checks, plan reviews, and other provider applications for certain users. Visit our webpage for more information.
Scam targeting U.S. Bank customers
DHS is aware of an organized impersonation scam that targets U.S. Bank customers. Impersonators are contacting customers by phone, posing as representatives from the U.S. Bank Fraud Department. They may claim issues with recently initiated wire transfers. The DHS DQA Provider Portal uses U.S. Bank for the payment of fees. Please be aware of this impersonation scam if you are paying fees through the DHS DQA Provider Portal.
- Assisted Living Facility Request for Waiver, Approval, Variance, or Exception, F-62548
- Assisted Living Facility Self-Report, F-02208
- Construction/Remodeling Plan Review for Health Care Facilities - Find information on submitting a plan for construction or remodeling of a health care facility.
- See the Wisconsin Caregiver Program site for forms and information regarding background checks.
- Report Abuse, Neglect, or Misappropriation - Learn about reporting and timing requirements for any claims of abuse or neglect, or misappropriation of client property.