Community-Based Residential Facilities: Forms

This page includes forms related to community-based residential facilities (CBRFs) in Wisconsin.

Select a link to learn more:

• Assisted Living Facility Request for Waiver, Approval, Variance, or Exception, F-62548
• Assisted Living Facility Self-Report, F-02208
• CBRF Fire Inspection, F-60795
• CBRF Resident Rights Complaint Report, F-62430
• CBRF Resident Satisfaction Evaluation, F-62372
• Client Rights Office - Find forms and other information.
• Construction/Remodeling Plan Review for Health Care Facilities - Find requirements and forms.
• Health Care Facility Fire Report, F-62500
• Resident Evacuation Assessment, F-62373
• Self Supervision Evaluation and Waiver Request, F-60309
• Significant Change in Health Screening Instrument Model Form, F-62370
• Waiver of Hospice or Home Health Services by a Terminally Ill Resident of a CBRF, F-62369