This form is used for submitting exception requests to the Child Welfare Licensing Section for Administrative Rules DCF 52, DCF 54, DCF 57 and exception and extension requests to Administrative Rule DCF 59. Completion of this form requires attaching a completed DCF-F-5023-E Child Welfare Request for Exception or DCF-F-5085-E Child Welfare Request for Exception-Age.
If using this form to submit a request for extension for Shelter Care (SC) stay, a completed DCF-F-2601 Child Welfare Licensing Shelter Care Extension may be attached but is not mandatory. If the SC choses to submit the request on another form, the SC must include child name, child date of birth, date of placement, and the reason for the extension request.
A separate form must be completed for each exception/extension request.
Do not use this form to submit exception requests to Administrative Rule DCF 56.
You should receive an automated email response within 10 minutes of submission of this form. If you do not receive this response, please notify licensing staff by emailing dcfcwlsexceptionrequest@wisconsin.gov.
E.g. DCF 57.16(1)(a)
