Construction Project 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 your email with the PDF files attached to dhsdqaplanreview@dhs.wisconsin.gov.
You must mail the following to the plan intake coordinator:
- Payment for the plan submittal fees (in the form of a check)
- A copy of the completed Plan Approval Application
Address your envelope to the Wisconsin Department of Health Services (DHS):
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.
Resources
- Plan Approval Application, F-62333 (Word)
- Permission to Start Construction Request, F-62457 (Word) - Permission to start is required for footing and foundation work only. Contact your local municipality for specific permitting criteria.
- DSPS Plumbing Plan Review in Health Care Facilities (PDF)
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:
- Email dhsdqaplanreview@dhs.wisconsin.gov
- Call 608-266-8016
See DQA numbered memo 23-002 (PDF) for more information.
Contact us
If you have questions regarding completing forms, contact the plan intake coordinator:
- Call 414-227-4085
Mailing address
DHS Division of Quality AssuranceATTN: Plan Intake Coordinator819 N. 6th St., Room 609BMilwaukee, WI 53203-1606