Rehabilitation Review Program

If you have an offense affecting your eligibility to work in direct-patient contact roles or to receive department approval, and you can demonstrate rehabilitation, you may apply for rehabilitation review. Use the DHS Rehabilitation Review Application, F-03331 form.

PLEASE NOTE: You must register for MyWisconsin ID prior to submitting the DHS Rehabilitation Review Application, F-03331.

If granted, rehabilitation approval may restore your eligibility to:

• Work in roles with direct patient contact
• Obtain approval for a license or certification
• Obtain approval to reside with clients in entity facilities

For additional information, see Rehabilitation Review Process, P-63130 (PDF).

PLEASE NOTE: Several documents must be uploaded to your Rehabilitation Review Application, including:

• A personal statement describing
  • Actions or the conduct that resulted in your conviction, finding of misconduct, or finding of child abuse and/or neglect
  • Impact of your actions or conduct on others
  • Reason(s) why you engaged in the action or conduct
• Reason(s) why you believe you should be approved for rehabilitation
• Confirmation email showing that you submitted a Rehabilitation Review Background Check request
• A signed and dated letter of recommendation from a current or past employer describing your character and job performance
• Three signed and dated character reference letters written by anyone that knows you well

The following documents may be required, based on your circumstances:

• Documentation of the offense
  • Criminal Complaint
  • Judgment of Conviction
  • Pending or existing criminal or civil arrests, warrants, judgments or other legal enforcement actions or injunctions
  • Pending investigation by a government or regulatory agency
  • Findings of child abuse or neglect
  • Findings of patient abuse, neglect, of misappropriation
  • Restriction on a credential held from the Department of Safety and Professional Services
• Documentation of treatment
  • Participation in the public or community service
  • Participation in the counseling, therapy, or other assessments
  • Participation in a treatment program for anger, aggression, or violence
  • Volunteer work
  • Treatment program for a sex offense
  • Payment for full restitution to the victim or community
  • Treatment program for parenting management
  • Treatment program for alcohol or other substance abuse
  • Other court-ordered program or procedures
  • Participation/completion of probation or parole
• Background check results from any other state of residence in the past 5 years
• Documentation related to military discharge (e.g., DD-214)

For questions, please email dhsrehabreviewcoordinator@dhs.wisconsin.gov.