Forms Search To find DCF Publications, please go to the publications search page. Below is a searchable list of forms used by programs and DCF staff. The table can be searched via title, number, and language or by scrolling through the complete list. Court forms can be found on the Wisconsin Court System web page. Child Support related court forms can be found on the BCS Court Resources and Forms web page. If you cannot find the form or publication you are looking for, contact DCF Agency Operations for assistance. Some forms and publications are preprinted and can be ordered from Document Sales. New Document Sales users will need to create a login and password in order to search for products, place and track orders. Any questions about Document Sales should be directed to Document Sales and Distribution at 608-243-2441. Number Title Language Type DCF-F-5190-E Verification of Out-of-Home Placement for Wisconsin Shares Eligibility English DOC DCF-F-5447-E Guardian ad Litem Request for Background Information regarding Guardianship Petition English DOC DCF-F-5448-E DMCPS In State Employment or Volunteer Background Check Request English DOC DCF-F-CFS782 Initial License Application - Day Camps for Children English DOC DCF-F-5180-E-S MyWiChildCare EBT Card Deactivation Notice Spanish DOC DCF-F-5180-E MyWiChildCare EBT Card Deactivation Notice English DOC DCF-F-5181-E-S MyWiChildCare EBT Card PIN Reset Notice Spanish DOC DCF-F-5181-E MyWiChildCare EBT Card PIN Reset Notice English DOC DCF-F-CFS4099 Instructions for Obtaining Child Care Licensing Rule Books and Commentary Manuals English PDF DCF-F-5370-E Kinship Care Eligibility Determination English DOC DCF-F-5371-E Voluntary Kinship Care Parental Consent English DOC DCF-F-5372-E Notification of Kinship Care Termination English DOC DCF-F-5373-E Advance Notice of Termination of Kinship Care at Age 18 English DOC DCF-F-5369-E Kinship Care Review of Eligibility and Notice of Change of Circumstance English DOC DCF-F-5401-E Notice of Eligibility for the Job Access Loan (JAL) Program English XLS DCF-F-5401-E-S Notice of Eligibility for the Job Access Loan (JAL) Program Spanish XLS DCF-F-5395-E Boys & Girls Clubs of Greater Milwaukee COVID-19 Alternate Activities Reporting Form English DOC DCF-F-5254-E Boys & Girls Clubs of Greater Milwaukee Wisconsin After 3 and Be Great: Graduate Programs Reporting Form English DOC DCF-F-5387-E Licensor Guide to the Caregiver Training Understanding Child Sex Trafficking in Wisconsin English DOC DCF-F-5305-E Child Care Provider Portal (CCPP) Access Request English DOC DCF-F-5384 Program Security and Confidentiality Attestation English PDF DCF-F-5383 Driver Training Checklist - Child Care Centers English PDF DCF-F-5383-E Driver Training Checklist - Child Care Centers English DOC DCF-F-5382-E-H Treatment Plan Review-Group Home Hmong DOC DCF-F-5382-E-S Treatment Plan Review-Group Home Spanish DOC DCF-F-5382-E Treatment Plan Review-Group Home English DOC DCF-F-5381-E Reference Check-Group Home English DOC DCF-F-5380-E Policy/Procedure Checklist-Shelter Care English DOC DCF-F-5379-E Discharge Summary-Group Home English DOC DCF-F-5378-E Child Welfare Continuing Education Record-Independent Reading/Video Viewing English DOC DCF-F-5377-E Assessment Plan-Group Home English DOC DCF-F-5365 Child Care Background Check Attestation English PDF DCF-F-5365-S Child Care Background Check Attestation Spanish PDF DCF-F-5361-E Family Foundations Home Visiting Program Budget Explanation English XLS DCF-F-5360-E Family Foundations Home Visiting Program Scope of Services English DOC DCF-F-5359-E Family Foundations Home Visiting Program Budget Summary English DOC DCF-F-5332-E Transitioning Youth from Ongoing Services to a TRA-DMCPS Due Date Tracker English XLS DCF-F-5331-E Petition for Appeal of Ineligibility Determination English DOC DCF-F-5329-E WI Shares Child Care Hourly In-Home Price Calculator for Two or More Children English XLS DCF-F-5325-E Request DCF Secretary for Event/Meeting/Engagement English DOC DCF-F-CFS2240-E Placement Verification Letter English DOC DCF-F-2629 Child Placing Agency/Treatment Foster Care Program Consent to Transport English DOC DCF-F-2922-E Open Records Request for Police Records English DOC DCF-F-5320-E Written Payment Agreement Checklist English DOC DCF-F-5211-E Domestic Abuse Contract Budget Revision Request English DOC DCF-F-2893-E Client Investigation Recommendation English DOC DCF-F-5315-E Child Description for Foster Home Placement Recruitment English DOC DCF-F-5296-S Background Check Request Spanish PDF DCF-F-5296-H Background Check Request Hmong PDF DCF-F-5314-E Application for Start-Up and/or Maintenance Funding for Relative Caregiver Support Groups English DOC DCF-F-5308-E-H Waiver of Administrative Hearing Hmong DOC DCF-F-5308-E-S Waiver of Administrative Hearing Spanish DOC DCF-F-5308-E Waiver of Administrative Hearing English DOC DCF-F-5110-E YoungStar Contract Renewal English DOC DCF-F-5110-E-S YoungStar Contract Renewal Spanish DOC DCF-F-5296-E Background Check Request Form English DOC DCF-F-5298-E Resident Care Staff Qualifications and Observation Log English DOC DCF-F-2672-E-S Acknowledgment: Receipt of Adoption Assistance Information Spanish DOC DCF-F-2672-E-H Acknowledgment: Receipt of Adoption Assistance Information Hmong DOC DCF-F-5290-E Child Specific Preadoption Preparation Training for Public Adoption English DOC DCF-F-5227-E Application to DCF for Exception to Ch. 50 (Public Adoption Home Study) English DOC DCF-F-2672-E Acknowledgment: Receipt of Adoption Assistance Information English DOC DCF-F-5287-E DMCPS Out-of-State Higher Level of Care Staffing Form English DOC DCF-F-5284-E Determination of "High Risk" Status for Adoption Assistance English DOC DCF-F-5046-E Education Passport English DOC F-44192 Child Care Immunization Record (DHS Form) English PDF DCF-F-CFS2074-E-S Safety Analysis and Plan Spanish DOC DCF-F-5277-E Functional Assessment Screening Tool English DOC DCF-F-2587-E Wisconsin Shares Participation Contract English DOC DCF-F-2587-E-S Wisconsin Shares Participation Contract Spanish DOC DCF-F-5276-E Communication Log English DOC DCF-F-5207-E Target Groups English DOC DCF-F-2904-E External Agency Agreement on Access to eWiSACWIS English DOC DCF-F-5223-2018 Wisconsin Works (W-2) Overpayment Worksheet 2018 English XLS DCF-F-5223-2019 Wisconsin Works (W-2) Overpayment Worksheet 2019 English XLS DCF-F-2624-E Request to Charge Capital Asset as a Direct Cost English DOC DCF-F-5224-E-H Provider Parent Payment Agreement Hmong DOC DCF-F-5224-E-S Provider Parent Payment Agreement Spanish DOC DCF-F-DWSP10784-E Fact Finding Review Summary and Decision English DOC DCF-F-5224-E Provider Parent Payment Agreement English DOC DCF-F-5237-E DMCPS Consent Request Form English DOC DCF-F-5238-E DMCPS Permanent Guardianship Request English DOC DCF-F-5219-E Adoption Assistance Rate Determination and Application for Private Adoptions English DOC DCF-F-5223 Wisconsin Works (W-2) Overpayment Worksheet 2016 and Earlier English PDF DCF-F-5223-2017 Wisconsin Works (W-2) Overpayment Worksheet 2017 English XLS DCF-F-5229 DCF Exceptions Panel Application - Addendum Ch. DCF 56.09(1m)(f) Admin. Code English DOC DCF-F-5216-E-S Feedback and Complaint Form Spanish DOC DCF-F-5216-E-H Feedback and Complaint Form Hmong DOC DCF-F-5216-E Feedback and Complaint Form English DOC DCF-F-5215 W-2 Agency Time Limit Extension Denial Record English DOC DCF-F-5214 W-2 Agency Time Limit Extension Approval Record English DOC DCF-F-2782-E Subsidized Guardianship Amendment Request - Option to Continue Current Rate English DOC DCF-F-2976-E-S Wisconsin Shares Inclusion Rate Request Spanish DOC DCF-F-5184-E Higher Level of Care Request English DOC DCF-F-5037-S Reschedule Review of the Initial Determination of Child Abuse and/or Neglect Spanish DOC DCF-F-5037-H Reschedule Review of the Initial Determination of Child Abuse and/or Neglect Hmong DOC DCF-F-5178-E-S Voluntary Repayment Agreement Spanish DOC DCF-F-5178-E-H Voluntary Repayment Agreement Hmong DOC DCF-F-5179-E Incident Report for Program Integrity Site Visit English DOC DCF-F-5160-E Caregiver Background Checks Substantially Related Investigation Report for Child Welfare Agencies English DOC DCF-F-5163-E-S Information Provided to the Wisconsin Adoption and Permanence Support Program Spanish DOC DCF-F-5163-E-H Information Provided to the Wisconsin Adoption and Permanence Support Program Hmong DOC DCF-F-CFS0362-E Licensing Checklist - Child Placing Agencies English DOC DCF-F-CFS0361-E Licensing Checklist - Shelter Care Facilities English DOC DCF-F-CFS0358-E Licensing Checklist - Group Homes DCF 57 English DOC DCF-F-CFS0354-E Licensing Checklist - Residential Care Centers DCF 52 English DOC DCF-F-5178-E Voluntary Repayment Agreement English DOC DCF-F-CFS0381-E Foster Home Record Checklist - Child Placing Agencies English DOC DCF-F-5177-E Request to Clarify Specific and Limited Circumstances Prior to Submitting an Application to Operate a Level 5 Exceptional Treatment Foster Home English DOC DCF-F-5156-E Child Description for Adoption Recruitment English DOC DCF-F-CFS2414-E Child Record Checklist - Shelter Care Facilities English DOC DCF-F-CFS2399-E Personnel Record Checklist - Shelter Care Facilities English DOC DCF-F-CFS2140-E Residential Care Center General Personnel Record Checklist English DOC DCF-F-CFS2139-E Resident Record Checklist - Residential Care Centers for Children and Youth English DOC DCF-F-CFS0383-E Personnel Record Checklist - Group Homes English DOC DCF-F-CFS0379-E Child Record Checklist - Group Homes English DOC DCF-F-2564-E-S Services and Accommodations to Help You Do Your W-2 Activities Spanish DOC DCF-F-5163-E Information Provided to the Wisconsin Adoption and Permanence Support Program English DOC DCF-F-5159-E Adoption Assistance Rate Determination and Application for Tribal or Customary Adoptions English DOC DCF-F-5158-E Interstate Compact on the Placement of Children (ICPC) Worker Statement Regarding Proposed Placement Resource English DOC DCF-F-5121-E BRITS Helpdesk Role Request / Set-Up English DOC DCF-F-5122-E BRITS Application - User Set-Up Form English DOC DCF-F-DWSW11652 Local Agency Data Security Staff English DOC DCF-F-5109-E-S YoungStar Contract Spanish DOC DCF-F-5112-E-S YoungStar Request for Off-Year Services Spanish DOC DCF-F-5129-E Disaster Plan English DOC DCF-F-CFS0872A Information for Out-of-Home Care Providers, Part A English DOC DCF-F-CFS0872B Information for Out-of-Home Care Providers, Part B English DOC DCF-F-110-E Agency Identification English DOC DCF-F-110 Agency Identification English PDF DCF-F-124 Employer Payment Coupon English PDF DCF-F-126 Mental Health Report English PDF DCF-F-139-E Statement of Economic Interest Form English DOC DCF-F-140-E Request For: Write off or Adjustment English DOC DCF-F-156-E Service Delivery Discrimination Complaint English DOC DCF-F-CFS2099 Kinship Care Caretaker Application (for Milwaukee County Residents) English PDF DCF-F-CFS2099A Kinship Care Documentation of Child's Residence (for Milwaukee County Residents) English PDF DCF-F-2276B-E Tribal Agreement on Access to eWiSACWIS English DOC DCF-F-2405 Pre-Camp Training Documentation - Day Camps English PDF DCF-F-2405 Pre-Camp Training Documentation - Day Camps English DOC DCF-F-2409 Policy Checklist - Day Camps English PDF DCF-F-2424 Counselor-To-Child Ratio Worksheet Day Camps for Children English DOC DCF-F-2424 Counselor-To-Child Ratio Worksheet Day Camps for Children English PDF DCF-F-242-E Child Record Checklist - Certified Child Care English DOC DCF-F-2438-E Daily Attendance Record - Licensed Child Care Centers English DOC DCF-F-2438-S Daily Attendance Record - Licensed Child Care Centers Spanish PDF DCF-F-2440 Assessment and Treatment Plan - Residential Care Centers for Children and Youth English DOC DCF-F-2452 Child Record Checklist - Day Camps for Children English DOC DCF-F-2452 Child Record Checklist - Day Camps for Children English PDF DCF-F-2453-E Staff Record Checklist - Day Camps for Children English DOC DCF-F-2453 Staff Record Checklist - Day Camps for Children English PDF DCF-F-2455 Counselor-to-Child Ratio While Swimming Worksheet Day Camps for Children English DOC DCF-F-2464-E Emergency Higher Level of Care Approval English DOC DCF-F-2465 Staff-to-Child Ratio While Swimming Worksheet Group and Family Child Care English PDF DCF-F-2466-E Civil Rights Service Delivery Discrimination Complaint English DOC DCF-F-2466-E-H Civil Rights Service Delivery Discrimination Complaint Hmong PDF DCF-F-2466-E-S Civil Rights Service Delivery Discrimination Complaint Spanish PDF DCF-F-2470-E Review of the Use of Child Welfare Funding English DOC DCF-F-2473-E Notification of the Removal of a Child from the Custody of his or her Parent and Placement into Out-of-Home Care English DOC DCF-F-2473-E-S Notification of the Removal of a Child from the Custody of his or her Parent and Placement into Out-of-Home Care Spanish DOC DCF-F-2474-E Guide for Foster Parents and Other Physical Custodians to Provide Information at Court Proceedings English DOC DCF-F-2479-E Relative Caregiver Licensing Decision English DOC DCF-F-2483-E Joint Court Ordered Kinship Care and Foster Care Application English DOC DCF-F-2483-E-H Joint Court Ordered Kinship Care and Foster Care Application Hmong PDF DCF-F-2483-E-S Joint Court Ordered Kinship Care and Foster Care Application Spanish PDF DCF-F-2491 Ordering Information - Child Welfare Licensing Initial Application Packets English DOC DCF-F-2501-E Group Home Registration Requirements English DOC DCF-F-2503 Authorization to Consent to Medical Treatment English PDF DCF-F-2503-H Authorization to Consent to Medical Treatment Hmong PDF DCF-F-2503-S Authorization to Consent to Medical Treatment Spanish PDF DCF-F-2539-E Relative Caregiver Agreement Child Placed in Out-of-Home Care by Agency English DOC DCF-F-2539-E-H Relative Caregiver Agreement Child Placed in Out-of-Home Care by Agency Hmong DOC DCF-F-2539-E-S Relative Caregiver Agreement Child Placed in Out-of-Home Care by Agency Spanish DOC DCF-F-2540-E Permanency Consultation English DOC DCF-F-2549-E Independent Living Transition to Discharge (ILTD)Plan English DOC DCF-F-2556-E Complainant Consent/Release English DOC DCF-F-2556-E-H Complainant Consent/Release Hmong PDF DCF-F-2556-E-S Complainant Consent/Release Spanish PDF DCF-F-2559-E Application for Certification and Child Placement Level 5 Foster Home English DOC DCF-F-2564-E Services and Accommodations to Help You Do Your W-2 Activities English DOC DCF-F-2565-E Wisconsin Works W-2 Formal Assessment Agreement English DOC DCF-F-2565-E-S Wisconsin Works W-2 Formal Assessment Agreement Spanish DOC DCF-F-2574 National Youth in Transition Database (NYTD) Survey for Wisconsin Youth Age 17 English PDF DCF-F-2582-E Job Access Loan, W-2 Auxiliary Payment and/or Performance Outcome Payment Claim Approval Designation English DOC DCF-F-2583-E Child Placing Agency (DCF 54) Registration English DOC DCF-F-2584-E Wisconsin TANF Months Verification English DOC DCF-F-2596-E Assessment/Stabilization Center Registration English DOC DCF-F-2604 Kinship Relationship Verification English PDF DCF-F-2604-H Kinship Relationship Verification Hmong PDF DCF-F-2604-S Kinship Relationship Verification Spanish PDF DCF-F-2606-E Request for Emergency Service Funds for DMCPS Families English DOC DCF-F-2609-E Request for Child Protective Services (CPS) Background Check English DOC DCF-F-2609-E Request for Child Protective Services (CPS) Background Check English PDF DCF-F-2611-E Child and Adolescent Needs and Strenghts (CANS) Results 5-21 English DOC DCF-F-2612-E Child and Adolescent Needs and Strengths (CANS) Results 0-5 English DOC DCF-F-2619-E Licensor Guide to the Web-Based Foster Parent Pre-Placement Training English DOC DCF-F-2622-E YoungStar Change English DOC DCF-F-2630 Removal of Records Receipt - Child Care Centers English PDF DCF-F-2630-H Removal of Records Receipt - Child Care Centers Hmong PDF DCF-F-2630-S Removal of Records Receipt - Child Care Centers Spanish PDF DCF-F-2651-E Application to DCF Exceptions Panel for Exception to Foster Parent Training Requirements English DOC DCF-F-2651-E Application to DCF Exceptions Panel for Exception to Foster Parent Training Requirements English PDF DCF-F-2666-E Wisconsin Child Care Regulatory System (WISCCRS Access Report) English DOC DCF-F-2668 Application for Assistant, Employee, Substitute or Volunteer English PDF DCF-F-2685-E Individualized Training Plan English PDF DCF-F-2685-E Individualized Training Plan English DOC DCF-F-2686-E Fact Finding Review Denial Notice English DOC DCF-F-2686-E-S Fact Finding Review Denial Notice Spanish DOC DCF-F-2694-E Like-Kin Subsidized Guardianship Request English DOC DCF-F-2695-E Guardianship Screening English DOC DCF-F-2695-E Guardianship Screening English PDF DCF-F-2696-E Proposed Rate Request English DOC DCF-F-2723-E Notice of Noncooperation with Program Requirements English DOC DCF-F-2723-E-S Notice of Noncooperation with Program Requirements Spanish DOC DCF-F-2742-E Child Care Authorization Worksheet English PDF DCF-F-2742-E Child Care Authorization Worksheet English DOC DCF-F-2746-E Waiver Request English DOC DCF-F-2755-E Intensive In-Home Services Extension Request English DOC DCF-F-2758-E Child and Adolescent Needs and Strengths (CANS) 5-21 Amendment Confirmation of Needs Subsidized Guardianship/Adoption Assistance English PDF DCF-F-2759-E Child and Adolescent Needs and Strengths (CANS) 0-5 Amendment Confirmation of Needs Subsidized Guardianship/Adoption Assistance English PDF DCF-F-2783-E Subsidized Guardianship Amendment Request - Confirmation of Needs Behavioral Characteristic English DOC DCF-F-2784-E Subsidized Guardianship Amendment Request - Confirmation of Needs Physical - Personal Care Characteristics English DOC DCF-F-2785-E Subsidized Guardianship Amendment Request - Confirmation of Needs Emotional Characteristics English DOC DCF-F-2794-E Extraordinary Payment Request English DOC DCF-F-2797 Permanency Options in Brief Appendix A English PDF DCF-F-2809-E Request for Rate Regulation Exception English DOC DCF-F-2813-E Subsidized Guardianship Amendment Request English DOC DCF-F-2827-E Request for Approval of Foster Care Maintenance Rate Over $2,000 per Month English DOC DCF-F-2829 National Youth in Transition Database (NYTD) Survey for Wisconsin Youth Age 19 English PDF DCF-F-2831-E Assessment and Discharge Summary - Respite Group Homes English DOC DCF-F-2835 Wisconsin Shares Child Care Registration English PDF DCF-F-2835-S Wisconsin Shares Child Care Registration Spanish PDF DCF-F-2836 Wisconsin Shares Child Care Interview English PDF DCF-F-2836-S Wisconsin Shares Child Care Interview Spanish PDF DCF-F-2841-E WI Shares Child Care Subsidy Admin SharePoint Site External User Access Request (Non-CSAW Users) English DOC DCF-F-2844-E Closed Adoption Home Files English DOC DCF-F-2848-E Subsidized Guardianship (SG) Program Application and Decision English DOC DCF-F-2848-E-H Subsidized Guardianship (SF) Program Application and Decision Hmong PDF DCF-F-2848-E-S Subsidized Guardianship (SF) Program Application and Decision Spanish PDF DCF-F-2850-E Policy - Procedure Checklist - Child Placing Agency English DOC DCF-F-2853-E Child Care Certification Agency Review Questionnaire English DOC DCF-F-2855-E Individual Operator Records Review English DOC DCF-F-2857-E Rehabilitation Review Appeals Report Instructions English DOC DCF-F-2867-E Subsidized Guardianship Amendment Request - Age Birth to 5 Child and Adolescent Needs and Strengths (CANS) Version English DOC DCF-F-2868-E Subsidized Guardianship Amendment Request - Age 5-21 Child and Adolescent Needs and Strengths (CANS) Version English DOC DCF-F-2869-E Subsidized Guardianship Amendment Request - Confirmation of Needs Emotional Characteristics (Ages Birth to 5) English DOC DCF-F-2870-E Subsidized Guardianship Amendment Request - Confirmation of Needs Emotional Characteristics (Ages 5 to 21) English DOC DCF-F-2871-E Subsidized Guardianship Amendment Request - Confirmation of Needs Behavioral Characteristics (Birth to 5) English DOC DCF-F-2872-E Subsidized Guardianship Amendment Request - Confirmation of Needs Behavioral Characteristics (Ages 5 to 21) English DOC DCF-F-2873-E Subsidized Guardianship Amendment Request - Confirmation of Needs Physical/Personal Care Characteristics (Birth to 5) English DOC DCF-F-2874-E Subsidized Guardianship Amendment Request - Confirmation of Needs Physical/Personal Care Characteristics (Ages 5 to 21) English DOC DCF-F-2903-E Web Access Request for W-2 Plans English DOC DCF-F-2906-E Notice of Extension of Informal Disposition Agreement English DOC DCF-F-2906-E-H Notice of Extension of Informal Disposition Agreement Hmong DOC DCF-F-2906-E-S Notice of Extension of Informal Disposition Agreement Spanish DOC DCF-F-2907-E Notice of Termination of Informal Disposition Agreement English DOC DCF-F-2907-E-H Notice of Termination of Informal Disposition Agreement Hmong DOC DCF-F-2907-E-S Notice of Termination of Informal Disposition Agreement Spanish DOC DCF-F-2908-E Notice to the District Attorney of Cancellation of Informal Disposition Agreement English DOC DCF-F-2923-E Request for Access English DOC DCF-F-2925-E Placement Verification Request English DOC DCF-F-2926-E Address Information Request for Department of Motor Vehicles English DOC DCF-F-2927-E Household Verification Request English DOC DCF-F-2928-E Post Office Address Information Request English DOC DCF-F-2929-E Basic Education, Technical College, or Other Confirmation of Classes English DOC DCF-F-2930-E BPI Investigation Tracking Database Access Request English DOC DCF-F-2932-E Residential Care Center Regisration Requirement (DCF 52) Checklist English DOC DCF-F-307-E Special Needs Program W-2 Referral English DOC DCF-F-368-E Disability Certification Exception English DOC DCF-F-368-E Disability Certification Exception English PDF DCF-F-369-E Confidential Information Release Authorization English DOC DCF-F-369-H Confidential Information Release Authorization Hmong PDF DCF-F-369-E-S Confidential Information Release Authorization Spanish DOC DCF-F-370-E Documents Submitted at Fact Finding Review English DOC DCF-F-370-E-S Documents Submitted at Fact Finding Review Spanish DOC DCF-F-380-E Request for Address of Wisconsin Works (W-2) Recipients Involved in Legal Proceedings English DOC DCF-F-380-E Request for Address of Wisconsin Works (W-2) Recipients Involved in Legal Proceedings English PDF DCF-F-382-E Wisconsin Works (W-2) Overpayment Notice English DOC DCF-F-391 Certification Regarding Debarment and Suspension Instructions English DOC DCF-F-406-E Supervised Independent Living (SIL) Placement Referral English DOC DCF-F-4070-E At Risk Pregnancy (ARP) Medical Information/Verification English DOC DCF-F-4095-E YoungStar Case Management System Access Request English DOC DCF-F-418-E Rehabilitation Review Panel Decision Report with Instructions English DOC DCF-F-419 Rehabilitation Review Application Instructions English PDF DCF-F-419-H Rehabilitation Review Application Instructions Hmong PDF DCF-F-419-S Rehabilitation Review Application Instructions Spanish PDF DCF-F-425-E Child Care Agency Annual Summary: All Contract Functions English DOC DCF-F-432-E Request for Waiver of Eligibility Restrictions for Child Care Assistance English DOC DCF-F-452-E Child Care Overpayment Worksheet English XLS DCF-F-452-E-H Child Care Overpayment Worksheet Hmong XLS DCF-F-452-E-S Child Care Overpayment Worksheet Spanish XLS DCF-F-453-E Initial Assessment Case Reading Protocol and Review Tool English DOC DCF-F-62-E Daily Attendance Record - Certified Child Care English PDF DCF-F-62-E Daily Attendance Record - Certified Child Care English DOC DCF-F-62-E-S Daily Attendance Record - Certified Child Care Spanish PDF DCF-F-82-E Affidavit of Lost, Destroyed, or Stolen checks or Benefits English DOC DCF-F-CFS0019A-E Declaration of Paternal Interest English DOC DCF-F-CFS0019B-E Declaration of Paternal Interest Revocation English DOC DCF-F-CFS0019-E Court Inquiry on Declaration of Paternal Interest English DOC DCF-F-CFS0053A Staff Continuing Education Record -Child Care Centers English DOC DCF-F-CFS0053-E Staff Record - Child Care Centers English DOC DCF-F-CFS0053-E Staff Record - Child Care Centers English PDF DCF-F-CFS0053-E-S Staff Record - Child Care Centers Spanish PDF DCF-F-CFS0053-H Staff Record - Child Care Centers Hmong PDF DCF-F-CFS0055 Incident Report - Regulated Child Care Centers English PDF DCF-F-CFS0055 Incident Report - Regulated Child Care Centers English DOC DCF-F-CFS0056-S Transportation Permission - Child Care Centers Spanish PDF DCF-F-CFS0056-E Transportation Permission - Child Care Centers English DOC DCF-F-CFS0057-E Informed Consent for Observation or Testing by an Outside Agency - Child Care Centers English PDF DCF-F-CFS0059-E Authorization to Administer Medication - Child Care Centers English DOC DCF-F-CFS0059-E-S Authorization to Administer Medication - Child Care Centers Spanish PDF DCF-F-CFS0060-E Child Health Report - Child Care Centers English DOC DCF-F-CFS0061-E Intake for Child Under 2 Years - Child Care Centers English DOC DCF-F-CFS0061-S Intake for Child Under 2 Years - Child Care Centers Spanish PDF DCF-F-CFS0062 Child Care Enrollment English PDF DCF-F-CFS0062-E Child Care Enrollment English DOC DCF-F-CFS0062-H Child Care Enrollment Hmong PDF DCF-F-CFS0062-S Child Care Enrollment Spanish PDF DCF-F-CFS0063 Licensing Checklist - Group Child Care Centers DCF 251 English PDF DCF-F-CFS0069 Licensing Checklist - Family Child Care Centers DCF 250 English PDF DCF-F-CFS0070 Licensing Checklist - Day Camps for Children English PDF DCF-F-CFS0074-E Adoption Assistance Agreement English DOC DCF-F-CFS0074-E-H Adoption Assistance Agreement Hmong PDF DCF-F-CFS0074-E-S Adoption Assistance Agreement Spanish PDF DCF-F-CFS0078-E Staff-to-Child Ratio Worksheet Group Child Care Centers English PDF DCF-F-CFS0078-E Staff-to-Child Ratio Worksheet Group Child Care Centers English DOC DCF-F-CFS0100A ICPC Placement Request English DOC DCF-F-CFS0100B ICPC Report on Children's Placement Date or Change or Placement English DOC DCF-F-CFS0100T-E Tribal ICPC Placement Documentation English DOC DCF-F-CFS0103 Child's Personal Record English PDF DCF-F-CFS0104-E Alternate Arrival / Release Agreement - Child care Centers English DOC DCF-F-CFS0107-E Foster Home Agreement Child Placed in Out-of-Home Care by Agency English DOC DCF-F-CFS0116-E Foster Parent Insurance Program - Claim of Loss or Damage English DOC DCF-F-CFS0116 Foster Parent Insurance Program - Claim of Loss or Damage English PDF DCF-F-CFS0117-E Foster Parent Insurance Program Verification of Claim English DOC DCF-F-CFS0117-E Foster Parent Insurance Program Verification of Claim English PDF DCF-F-CFS0134-E Court Report for Centralized Birth Record English DOC DCF-F-CFS0137 Foreign Adoption Bond English PDF DCF-F-CFS0137-H Foreign Adoption Bond Hmong PDF DCF-F-CFS0137-S Foreign Adoption Bond Spanish PDF DCF-F-CFS0139 Record of Adoption English PDF DCF-F-CFS0139-E Record of Adoption English DOC DCF-F-CFS0140 Adoptive Family Placement Agreement English PDF DCF-F-CFS0142-E Affidavit English DOC DCF-F-CFS0142-E-H Affidavit Hmong PDF DCF-F-CFS0142-E-S Affidavit Spanish PDF DCF-F-CFS0144-E Adoption Search Application English DOC DCF-F-CFS0149A-E Family History Questionnaire Medical/Genetic - Pregnancy and Delivery Information English DOC DCF-F-CFS0149A-E-H Family History Questionnaire Medical/Genetic - Pregnancy and Delivery Information Hmong PDF DCF-F-CFS0149A-E-S Family History Questionnaire Medical/Genetic - Pregnancy and Delivery Information Spanish PDF DCF-F-CFS0149-E Family History Questionnaire Medical/Genetic English DOC DCF-F-CFS0149-E-H Family History Questionnaire Medical/Genetic Hmong PDF DCF-F-CFS0149-E-S Family History Questionnaire Medical/Genetic Spanish PDF DCF-F-CFS0297-E Exception Request English DOC DCF-F-CFS0353 Sanitation Checklist - Residential Care Centers English PDF DCF-F-CFS0357 Fire Safety Inspection - Residential Care Centers English PDF DCF-F-CFS0367-E Community Advisory Committee Documentation English DOC DCF-F-CFS0369 Personnel Record Checklist - Child Placing Agencies English PDF DCF-F-CFS0380-E Foster Child Record Checklist Child Placing Agency English DOC DCF-F-CFS0384 Child Welfare Facility Staff Health Report English PDF DCF-F-CFS0459-E Adoption of Children with an Adoption Assistance Agreement One Time Expense Reimbursement English DOC DCF-F-CFS0460 Safety and Emergency Response Documentation - Family Child Care Centers English PDF DCF-F-CFS0543 Safety and Emergency Response Documentation - Group Child Care Centers English PDF DCF-F-CFS0787 Child Foster Care Licensing Checklist English PDF DCF-F-CFS0828 Adoptive Parent Health Report English PDF DCF-F-CFS0834 Uniform Foster Care Rate Setting English DOC DCF-F-CFS0847-E Application to DCF Exceptions Panel for Exception to Ch. DCF 56 (Foster Home Licensing) English PDF DCF-F-CFS0847-E Application to DCF Exceptions Panel for Exception to Ch. DCF 56 (Foster Home Licensing) English DOC DCF-F-CFS0857-E Adoption Investigation Report to Circuit Court English DOC DCF-F-CFS0909 Fire Safety Inspection - Group Homes English PDF DCF-F-CFS0962 Adoption Assistance Changes and Requests English DOC DCF-F-CFS0984-E Adoption Assistance High School Information English DOC DCF-F-CFS0997 Medical Services Consent English PDF DCF-F-CFS0997-H Medical Services Consent Hmong PDF DCF-F-CFS0997-S Medical Services Consent Spanish PDF DCF-F-CFS1590 Voluntary Placement Agreement English DOC DCF-F-CFS1590-E-H Voluntary Placement Agreement Hmong PDF DCF-F-CFS1590-E-S Voluntary Placement Agreement Spanish PDF DCF-F-CFS1675 Child Record Checklist - Child Care Centers English DOC DCF-F-CFS2016-E Request for Confirmation of Child's Indian Status English PDF DCF-F-CFS2017-E Notice of Involuntary Child Custody Proceeding Involving an Indian Child English PDF DCF-F-CFS2022 Child Care Inquiry Packet Request English PDF DCF-F-CFS2023-H Kinship Care Payment Application Hmong PDF DCF-F-CFS2023-S Kinship Care Payment Application Spanish PDF DCF-F-CFS2026 Staff Orientation Checklist - Group Child Care Centers English DOC DCF-F-CFS2027 Volunteer Training Confirmation - Group Child Care Centers English PDF DCF-F-CFS2048 Policy Checklist - Group Child Care English PDF DCF-F-CFS2048-S Policy Checklist - Group Child Care Spanish PDF DCF-F-CFS2050 After Hours Alert English DOC DCF-F-CFS2071 Request for Emergency Detention or Pick-up Orders English DOC DCF-F-CFS2088-E Child to be Removed from Foster Home, Treatment Foster Home, or Group Home English DOC DCF-F-CFS2096 Kinship Care Referral for Child Support Services English PDF DCF-F-CFS2096-E Kinship Care Referral for Child Support Services English DOC DCF-F-CFS2096-S Kinship Care Referral for Child Support Services Spanish PDF DCF-F-CFS2096-E-S Kinship Care Referral for Child Support Services Spanish DOC DCF-F-CFS2097 Kinship Care Payment Termination Notice English PDF DCF-F-CFS2099A-H Kinship Care Caretaker Application (for Milwaukee County Residents) Hmong PDF DCF-F-CFS2099A-S Kinship Care Documentation of Child's Residence (for Milwaukee County Residents) Spanish PDF DCF-F-CFS2099-H Kinship Care Caretaker Application (for Milwaukee County Residents) Hmong PDF DCF-F-CFS2099-S Kinship Care Caretaker Application (for Milwaukee County Residents) Spanish PDF DCF-F-CFS-2100A-E Kinship Care Case Data Collection English DOC DCF-F-CFS2100-E Kinship Care Case Data Collection English DOC DCF-F-CFS2114-E Continuing Education Record - Independent Reading-Video Viewing English DOC DCF-F-CFS2114-E Continuing Education Record - Independent Reading-Video Viewing English PDF DCF-F-CFS2118-E-S Original Disposition Report to the Court Spanish PDF DCF-F-CFS2130-E Out-of-Home Care Support Plan Evaluation / Revision English DOC DCF-F-CFS2131-E Out-of-Home Care Support Plan English DOC DCF-F-CFS2142 Staff Continuing Training Record Child Welfare Programs English PDF DCF-F-CFS2146-E Serious Incident Report English DOC DCF-F-CFS2149 Exceptions Panel Second License Application English DOC DCF-F-CFS2150 Notification of Court Hearing English PDF DCF-F-CFS2150-H Notification of Court Hearing Hmong PDF DCF-F-CFS2150-S Notification of Court Hearing Spanish PDF DCF-F-CFS2152 Adolescent Assessment / Placement Stabilization Center Admission English PDF DCF-F-CFS2155-E Adoptive Placement Checklist - Child Placing Agencies International English DOC DCF-F-CFS2157-E Adoption Assistance Agreement Amendment Payment Reduction - Termination English DOC DCF-F-CFS2157-E-H Adoption Assistance Agreement Amendment Payment Reduction - Termination Hmong DOC DCF-F-CFS2157-E-S Adoption Assistance Agreement Amendment Payment Reduction - Termination Spanish DOC DCF-F-CFS2167-E Kinship Care School Verification English DOC DCF-F-CFS2167-H Kinship Care School Verification Hmong PDF DCF-F-CFS2167-S Kinship Care School Verification Spanish PDF DCF-F-CFS2168 Residential Care Center Policy / Procedure Checklist English DOC DCF-F-CFS2172 Residential Care Center Child Abuse and Neglect Reporting and Confidentiality Responsibilities English PDF DCF-F-CFS2183 Residential Care Center Statutorily Reportable Death English DOC DCF-F-CFS2185 Electronic Deposit Authorization for Provider Payment English PDF DCF-F-CFS2186 Notice to Foster Parents Regarding Confidentiality of Records English PDF DCF-F-CFS2186-S Notice to Foster Parents Regarding Confidentiality of Records Spanish PDF DCF-F-CFS2187-E Foster Home Licensure Notification English DOC DCF-F-CFS2189-E Out-of-Home Placement Notification or Recommended Placement Notification English DOC DCF-F-CFS2190-E Kinship Care Long Term Agreement English DOC DCF-F-CFS2191 DCF 12 Negative Action Notice English PDF DCF-F-CFS2197-E DCF Scholarship Application for Youth in Out-of-Home Care English DOC DCF-F-CFS2197-E-H DCF Scholarship Application for Youth in Out-of-Home Care Hmong DOC DCF-F-CFS2197-E-S DCF Scholarship Application for Youth in Out-of-Home Care Spanish DOC DCF-F-CFS2198-E Foster Parent Insurance Program - Damage Claim Checklist English DOC DCF-F-CFS2202-E Kinship Care Denial of Payment and Appeal Rights English DOC DCF-F-CFS2237-E Foster Care or Treatment Foster Care License Revocation English DOC DCF-F-CFS2241-S Initial Licensing Checklist - Family Child Care Centers Spanish PDF DCF-F-CFS2251-E Independent Living Services Checklist (Optional) English DOC DCF-F-CFS2255-E Staff Orientation Checklist - Family Child Care Centers English DOC DCF-F-CFS2255-S Staff Orientation Checklist - Family Child Care Centers Spanish PDF DCF-F-CFS2256-E Independent Living Transition Plan English DOC DCF-F-CFS2257-E Notice Of County's Intent Not to Pursue Extension of Dispositional Order English DOC DCF-F-CFS2259-E Adoptive Placement Checklist - Child Placing Agency - Domestic English DOC DCF-F-CFS2260 Adoption Portfolio Contents Acknowledgement English PDF DCF-F-CFS2275 eWiSACWIS User Agreement English PDF DCF-F-CFS2316 Infant Relinquishment - Questions About You and the Infant English PDF DCF-F-CFS2322-E Screening for Child's Status as Indian English PDF DCF-F-CFS2322-E Screening for Child's Status as Indian English DOC DCF-F-CFS2323 Child's Biological Family History English PDF DCF-F-CFS2324-E Notification of Child's Removal from Foster Home English DOC DCF-F-CFS2325-E Notification of Child's Removal From Foster Home - Child in Home for Six Months or More - Emergency English DOC DCF-F-CFS2326-E License Denial Letter English DOC DCF-F-CFS2336-E ICPC Supervision Report English DOC DCF-F-CFS2338 Medication Administration Record - Group Homes for Children English DOC DCF-F-CFS2344 Building Inspection Report - Licensed Child Care Centers and Certified School-Age Programs English PDF DCF-F-CFS2345 Health History and Emergency Care Plan English DOC DCF-F-CFS2345-E-S Health History and Emergency Care Plan Spanish PDF DCF-F-CFS2347 Records Request English DOC DCF-F-CFS2356 Policy Checklist - Family Child Care Centers English PDF DCF-F-CFS2356-S Policy Checklist - Family Child Care Centers Spanish PDF DCF-F-CFS2365-E-H Subsidized Guardianship Agreement Hmong DOC DCF-F-CFS2365-E-S Subsidized Guardianship Agreement Spanish DOC DCF-F-CFS2366-E Guardian Family Assessment English DOC DCF-F-CFS2367 ICPC Adoption Request Checklist English PDF DCF-F-CFS2370-E Permanency Readiness and Preparation English DOC DCF-F-CFS2371-E Subsidized Guardianship High School Information English DOC DCF-F-CFS2372 Subsidized Guardianship Checklist / Routing English PDF DCF-F-CFS2378-E Policy Procedure Checklist - Group Homes for Children English DOC DCF-F-CFS2379-E Medical Services Consent - Child Welfare Facilities English DOC DCF-F-CFS2380-E Staff Volunteer Orientation Documentation - Group Homes English PDF DCF-F-CFS2381-E Resident Orientation Documentation - Group Home English PDF DCF-F-CFS2382A-E Intake Information - Group Home Resident English DOC DCF-F-CFS2382B-E Intake Information Group Home Resident Under 6 Years of Age English DOC DCF-F-CFS2383 Fire Safety and Emergency Response Documentation Residential Care Centers for Children and Youth English PDF DCF-F-CFS2384 Fire Safety and Emergency Response Documentation - Group Homes English PDF DCF-F-CFS2385 Fire Safety and Emergency Response Documentation - Shelter Care Facility English PDF DCF-F-CFS2386 Foster Home Information for WiSACWIS English DOC DCF-F-CFS2389-E Child Record - Shelter Care Facilities English DOC DCF-F-CFS2406-E Notice of Client Change of County Residence English DOC DCF-F-CFS2417-E-H Advance Notice of Termination of Adoption Assistance Hmong DOC DCF-F-CFS2417-E-S Advance Notice of Termination of Adoption Assistance Spanish DOC DCF-F-CFS2418-E-H Notice of Decision on Adoption Assistance Eligibility Status Hmong DOC DCF-F-CFS2418-E-S Notice of Decision on Adoption Assistance Eligibility Status Spanish DOC DCF-F-CFS2421-E-H Advance Notice of Termination of Subsidized Guardianship at Age 18 Hmong DOC DCF-F-CFS2421-E-S Advance Notice of Termination of Subsidized Guardianship at Age 18 Spanish DOC DCF-F-CFS2422 Required Central Staffing Information English DOC DCF-F-CFS2425 Voluntary Placement Agreement for an Indian Child English DOC DCF-F-CFS2427 Documentation of Caseworker Face to Face Contact with Child English PDF DCF-F-CFS2427 Documentation of Caseworker Face to Face Contact with Child English DOC DCF-F-CFS2428-E High Cost Pool Fund Application English XLS DCF-F-CFS2430-E Treatment Plan - Group Home English DOC DCF-F-CFS52 Vehicle Safety Inspection English PDF DCF-F-DES10787 Wisconsin Works (W-2) Overpayment Recoupment Notice English DOC DCF-F-DES10788 Wisconsin Works (W-2) Employability Plan English PDF DCF-F-DES10789 Learnfare Case Management Plan English PDF DCF-F-DES10790 Wisconsin Works (W-2) Repayment Agreement English DOC DCF-F-DES11087 Child Care Cash Collections/Repayments CARS Profile #9006 English PDF DCF-F-DES11297-E School Enrollment and Attendance Information Release English DOC DCF-F-DES2025 Request for Permission to Inspect Monthly Wisconsin Works (W-2) Report English PDF DCF-F-DETM13753-E Refugee Cash Assistance Eligibility - Notice of Decision English DOC DCF-F-DETM13753-B Refugee Cash Assistance Eligibility - Notice of Decision Bosnian PDF DCF-F-DETM13753-H Refugee Cash Assistance Eligibility - Notice of Decision Hmong PDF DCF-F-DETM13753-M Refugee Cash Assistance Eligibility - Notice of Decision Somali PDF DCF-F-DETM13753-R Refugee Cash Assistance Eligibility - Notice of Decision Russian PDF DCF-F-DETM13758-E Refugee Cash Assistance Ineligibility - Notice of Decision English DOC DCF-F-DETM13758-B Refugee Cash Assistance Ineligibility - Notice of Decision - Bosnian Bosnian PDF DCF-F-DETM13758-H Refugee Cash Assistance Ineligibility - Notice of Decision - Hmong Hmong PDF DCF-F-DETM13758-M Refugee Cash Assistance Ineligibility - Notice of Decision - Somali Somali PDF DCF-F-DETM13758-R Refugee Cash Assistance Ineligibility - Notice of Decision - Russian Russian PDF DCF-F-DETM13767 Refugee Cash Assistance Termination - Notice of Decision English PDF DCF-F-DETM13767-B Refugee Cash Assistance Termination - Notice of Decision Bosnian PDF DCF-F-DETM13767-H Refugee Cash Assistance Termination - Notice of Decision Hmong PDF DCF-F-DETM13767-M Refugee Cash Assistance Termination - Notice of Decision Somali PDF DCF-F-DETM13767-R Refugee Cash Assistance Termination - Notice of Decision Russian PDF DCF-F-DETM13768-E Refugee Cash Assistance Work Programs - Notice of Referral English DOC DCF-F-DETM13768-M Refugee Cash Assistance Work Programs - Notice of Referral Somali PDF DCF-F-DETM13770 Refugee Cash Assistance Sanctions - Notice of Decision English PDF DCF-F-DETM13770-B Refugee Cash Assistance Sanctions - Notice of Decision Bosnian PDF DCF-F-DETM13770-H Refugee Cash Assistance Sanctions - Notice of Decision Hmong PDF DCF-F-DETM13770-M Refugee Cash Assistance Sanctions - Notice of Decision Somali PDF DCF-F-DETM13770-R Refugee Cash Assistance Sanctions - Notice of Decision Russian PDF DCF-F-DETM15011-E Refugee Cash Assistance (RCA) Participation Agreement English DOC DCF-F-DETM15011-B Refugee Cash Assistance (RCA) Participation Agreement Bosnian PDF DCF-F-DETM15011-BRM Refugee Case Assistance (RCA)Participations Agreement Burmese PDF DCF-F-DETM15011-H Refugee Cash Assistance (RCA) Participation Agreement Hmong PDF DCF-F-DETM15011-M Refugee Cash Assistance (RCA) Participation Agreement Somali PDF DCF-F-DETM15011-R Refugee Cash Assistance (RCA) Participation Agreement Russian PDF DCF-F-DETM15011-Y Refugee Cash Assistance (RCA)Participation Agreement Arabic PDF DCF-F-DETM15721-E Refugee Cash Assistance Repayment Agreement English DOC DCF-F-DETM15721-B Refugee Cash Assistance Repayment Agreement Bosnian PDF DCF-F-DETM15721-H Refugee Cash Assistance Repayment Agreement Hmong PDF DCF-F-DETM15721-M Refugee Cash Assistance Repayment Agreement Somali PDF DCF-F-DETM15721-R Refugee Cash Assistance Repayment Agreement Russian PDF DCF-F-DETM15725 Sample Refugee Cash Assistance Overpayment Notice Letter English DOC DCF-F-DETM15725-B Sample Refugee Cash Assistance Overpayment Notice Letter Bosnian DOC DCF-F-DETM15725-H Sample Refugee Cash Assistance Overpayment Notice Letter Hmong DOC DCF-F-DETM15725-M Sample Refugee Cash Assistance Overpayment Notice Letter Somali DOC DCF-F-DETM15725-R Sample Refugee Cash Assistance Overpayment Notice Letter Russian DOC DCF-F-DWSC11002 Guardian's Application for Child Support Services English DOC DCF-F-DWSC11002-S Guardian's Application for Child Support Services Spanish PDF DCF-F-DWSC11053 Parent's Application for Child Support Services English DOC DCF-F-DWSC11053-H Parent's Application for Child Support Services Hmong PDF DCF-F-DWSC11053-S Parent's Application for Child Support Services Spanish PDF DCF-F-DWSC11376 Request for Privacy Protection (Child Support) English PDF DCF-F-DWSC11376-H Request for Privacy Protection (Child Support) Hmong PDF DCF-F-DWSC11376-S Request for Privacy Protection (Child Support) Spanish PDF DCF-F-DWSC11377 Confidential Information Release Authorization (Child Support) English PDF DCF-F-DWSC11377-H Confidential Information Release Authorization (Child Support) Hmong PDF DCF-F-DWSC11377-S Confidential Information Release Authorization (Child Support) Spanish PDF DCF-F-DWSC12181 Request for Re-Issuance of a Stale-Dated Check (Child Support) English PDF DCF-F-DWSC12181-H Request for Re-Issuance of a Stale-Dated Check (Child Support) Hmong PDF DCF-F-DWSC12181-S Request for Re-Issuance of a Stale-Dated Check (Child Support) Spanish PDF DCF-F-DWSC13124 Request for Abandoned Funds (Child Support) English PDF DCF-F-DWSC13124-H Request for Abandoned Funds (Child Support) Hmong PDF DCF-F-DWSC13124-S Request for Abandoned Funds (Child Support) Spanish PDF DCF-F-DWSC14363 Child Support Complaint Form English PDF DCF-F-DWSC14363-H Child Support Complaint Form Hmong PDF DCF-F-DWSC14363-S Child Support Complaint Form Spanish PDF DCF-F-DWSC15295 Child Support Account History English PDF DCF-F-DWSC15410 Account History Housing Letter English PDF DCF-F-DWSP10755-E Wisconsin Works (W-2) Participation Agreement English DOC DCF-F-DWSP10755-E-S Wisconsin Works (W-2) Participation Agreement Spanish DOC DCF-F-DWSP10779-E Authorization for Disclosure of Confidential Information English DOC DCF-F-DWSP10782-E Fact Finding Review Appointment Notice English DOC DCF-F-DWSP10782-E-S Fact Finding Review Appointment Notice Spanish DOC DCF-F-DWSP10783-E Request for a Wisconsin Works (W-2) Fact-Finding Review English DOC DCF-F-DWSP10783-E-S Request for a Wisconsin Works (W-2) Fact-Finding Review Spanish DOC DCF-F-DWSP10784-E-S Fact-Finding Review Summary and Decision Spanish DOC DCF-F-DWSP10786 Need to Care for Disabled Family Member English PDF DCF-F-DWSP10791-E Electronic Funds Transfer English DOC DCF-F-DWSP10791-E-S Electronic Funds Transfer Spanish DOC DCF-F-DWSP10792-E Wisconsin Works (W-2) Work Training Site Agreement English DOC DCF-F-DWSP11154 Back-Up Applicant/Participant Signature English PDF DCF-F-DWSP11154-H Back-Up Applicant/Participant Signature Hmong PDF DCF-F-DWSP11154-S Back-Up Applicant/Participant Signature Spanish PDF DCF-F-DWSP11155-E Fact Finding Review Voluntary Withdrawal English DOC DCF-F-DWSP11155-E-S Fact Finding Review Voluntary Withdrawal Spanish DOC DCF-F-DWSP13576 Domestic Abuse Screen Self-Administered Version English PDF DCF-F-DWSP13576-S Domestic Abuse Screen Self-Administered Version Spanish PDF DCF-F-DWSP14880-E Wisconsin Works (W-2) and Related Programs Registration English DOC DCF-F-DWSP14880-E-S Wisconsin Works (W-2) and Related Programs Registration Spanish DOC DCF-F-DWSP2010-1-E Emergency Assistance Application - Part 1 English DOC DCF-F-DWSP2010-1-E-S Emergency Assistance Application - Part 1 Spanish DOC DCF-F-DWSP2012 Medical Examination & Capacity English PDF DCF-F-DWSP2018-E Good Cause Notice English DOC DCF-F-DWSP2018-H Good Cause Notice Hmong PDF DCF-F-DWSP2018-E-S Good Cause Notice Spanish DOC DCF-F-DWSP2019-E Good Cause Claim English DOC DCF-F-DWSP2019-E-S Good Cause Claim Spanish DOC DCF-F-DWSP2233-E Voluntarily Declining Aid English DOC DCF-F-DWSP2233-SW Voluntarily Declining Aid Swahili PDF DCF-F-DWSP2233-BRM Voluntarily Declining Aid Burmese PDF DCF-F-DWSP2233-H Voluntarily Declining Aid Hmong PDF DCF-F-DWSP2233-E-S Voluntarily Declining Aid Spanish DOC DCF-F-DWSP2303-E Request for Verification English DOC DCF-F-DWSP2303-E-S Request for Verification Spanish DOC DCF-F-DWSP2375-E Wisconsin Works (W-2) and Related Programs Authorization of Participant Representation English DOC DCF-F-DWSP2375-S Wisconsin Works (W-2) and Related Programs Authorization of Participant Representation Spanish PDF DCF-F-DWSP2443 Household Budget Worksheet for Wisconsin Works (W-2) English PDF DCF-F-DWSP2471-E Wisconsin Works (W-2) and Related Programs Application English DOC DCF-F-DWSP2471-H Wisconsin Works (W-2) and Related Programs Application Hmong PDF DCF-F-DWSP2471-E-S Wisconsin Works (W-2) and Related Programs Application Spanish DOC DCF-F-DWSP2477-E Notice of Assignment English DOC DCF-F-DWSP2477-H Notice of Assignment Hmong PDF DCF-F-DWSP2477-E-S Notice of Assignment Spanish DOC DCF-F-DWSP2482-E Job Access Loan Application English DOC DCF-F-DWSP2482-E-H Job Access Loan Application Hmong PDF DCF-F-DWSP2482-E-S Job Access Loan Application Spanish DOC DCF-F-DWSP3080 Referral to Child Support English PDF DCF-F-DWSP3147 Vendor Payment Request English PDF DCF-F-DWSP3147-S Vendor Payment Request Spanish PDF DCF-F-DWSW11250-E Child Care (CC) Client Overpayment Notice English DOC DCF-F-DWSW11250-E-S Child Care (CC) Client Overpayment Notice Spanish DOC DCF-F-DWSW12956-E W-2 Supportive Services Plan English DOC DCF-F-DWSW12956-E-S W-2 Supportive Services Plan Spanish DOC DCF-F-DWSW13251-E Child Enrollment and Health History - Certified Child Care English DOC DCF-F-DWSW13251-E Child Enrollment and Health History - Certified Child Care English PDF DCF-F-DWSW13251-E-S Child Enrollment and Health History - Certified Child Care Spanish PDF DCF-F-DWSW13259-E Regulatory Agency Approval/Acknowledgement to Operate Child Care Business English PDF DCF-F-DWSW13259-E Regulatory Agency Approval / Acknowledgement to Operate Child Care Business English DOC DCF-F-13358-E Child Care Online Systems (CCPP/CSAW) Access Request for Agency Staff Only English DOC DCF-F-DWSW48 Certification Application-Family and In-Home Child Care Programs English PDF DCF-F-DWSW48-E Certification Application-Family and In-Home Child Care Programs English DOC DCF-F-DWSW48-S Certification Application-Family and In-Home Child Care Programs Spanish PDF DCF-F-DWSW49 Standards and Checklist-Family/In-Home Child Care Certification English PDF DCF-F-DWSW49-S Standards and Checklist-Family/In-Home Child Care Certification Spanish PDF DCF-F-CFS2185-S Electronic Deposit Authorization for Provider Payment Spanish PDF DCF-F-5023-E Child Welfare Request for Exception English DOC DCF-F-432-E-S Request for Waiver of Eligibility Restrictions for Child Care Assistance Spanish DOC DCF-F-5081-E Amendment Request to Extend Care to Residents 18 years of Age and over, but under 21 years of age English PDF DCF-F-2462 Application and Affidavit for Professional License English PDF DCF-F-2942-E Application For DCF Data English DOC DCF-F-2461 Application and Affidavit for Recreational License English PDF DCF-F-CFS2242-E Initial Licensing Checklist - Group Child Care Centers English PDF DCF-F-CFS2255 Staff Orientation Checklist - Family Child Care Centers English PDF DCF-F-CFS0059-E Authorization to Administer Medication - Child Care Centers English PDF DCF-F-2438 Daily Attendance Record - Licensed Child Care Centers English PDF DCF-F-242-E Child Record Checklist - Certified Child Care English PDF DCF-F-CFS2402A-E Multipurpose Home Study Report - Couples / Single (With Instructions) English DOC DCF-F-2623A-E Multipurpose Home Study Update / Recertification (With Instructions) English DOC DCF-F-2623B-E Multipurpose Home Study Update / Recertification English DOC DCF-F-CFS2402B-E Multipurpose Home Study Report - Couples / Single English DOC DCF-F-5032-E Adoption Case Closure Checklist English DOC DCF-F-231 Acceptance of Child Care Payments - DCF 201 Statement of Understanding and Agreement English PDF DCF-F-2455-E Counselor-to-Child Ratio While Swimming Worksheet Day Camps for Children English PDF DCF-F-CFS0053A Staff Continuing Education Record - Child Care Centers English PDF DCF-F-CFS0054 Staff Health Report - Child Care Provider English PDF DCF-F-CFS0056 Transportation Permission - Child Care Centers English PDF DCF-F-CFS0058 Field Trip or Other Activity Notification/Permission - Child Care Centers English PDF DCF-F-CFS0060-E Child Health Report - Child Care Centers English PDF DCF-F-CFS0061-E Intake for Child Under 2 Years - Child Care Centers English PDF DCF-F-CFS0104-E Alternate Arrival/Release Agreement - Child Care Centers English PDF DCF-F-CFS0297-E Exception Request English PDF DCF-F-CFS1675-E Child Record Checklist - Child Care Centers English PDF DCF-F-CFS1675A Staff Record Checklist - Group Child Care Centers Confidential - Do Not Post English PDF DCF-F-CFS1675A-E Staff Record Checklist - Group Child Care Centers Confidential - Do Not Post English DOC DCF-F-CFS2026 Staff Orientation Checklist - Group Child Care Centers English PDF DCF-F-CFS2051-E Staff Record Checklist - Family Child Care Centers English DOC DCF-F-CFS2051 Staff Record Checklist - Family Child Care Centers English PDF DCF-F-CFS2241 Initial Licensing Checklist - Family Child Care Centers English PDF DCF-F-CFS2345-E Health History and Emergency Care Plan English PDF DCF-F-5029-E Written Translation Professional Services Contract Request for Services English DOC DCF-F-2948-E In-Person Interpreter Professional Services Contract Request for Services English DOC DCF-F-5033-E Notice of Termination English DOC DCF-F-5030-E Voluntary Transition to Independent Living Agreement English DOC DCF-F-5040-E Voluntary Placement Agreement for Shelter Care English DOC DCF-F-5041-E Request by Shelter Care Facility to Accept Voluntary Placements and/or to Provide Respite Care Services English DOC DCF-F-5031-E Supervised Independent Living (SIL) Rate Setting English DOC DCF-F-5042-E Residential Care Center (RCC) Extend Care Funding Application English DOC DCF-F-5043-E Determination of Eligibility English DOC DCF-F-CFS2023-E Kinship Care Payment Application English DOC DCF-F-5040-E-H Voluntary Placement Agreement for Shelter Care Hmong PDF DCF-F-5040-E-S Voluntary Placement Agreement for Shelter Care Spanish PDF DCF-F-5035-E Notice of Initial Determination of Substantiated Child Maltreatment and Right to Request a Review English DOC DCF-F-5036-E Scheduled Review of the Initial Determination of Child Abuse and/or Neglect English DOC DCF-F-5037-E Reschedule Review of the Initial Determination of Child Abuse and/or Neglect English DOC DCF-F-5038a-E Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-Review Occurred English DOC DCF-F-5038b-E Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-No Response English DOC DCF-F-5038b-E-H Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-No Response Hmong DOC DCF-F-5038b-E-S Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-No Response Spanish DOC DCF-F-CFS2202-E-H Kinship Care Denial of Payment and Appeal Rights Hmong PDF DCF-F-CFS2202-E-S Kinship Care Denial of Payment and Appeal Rights Spanish PDF DCF-F-5030-E-H Voluntary Transition to Independent Living Agreement Hmong DOC DCF-F-5030-E-S Voluntary Transition to Independent Living Agreement Spanish DOC DCF-F-5036-E-H Scheduled Review of the Initial Determination of Child Abuse and/or Neglect Hmong DOC DCF-F-5036-E-S Scheduled Review of the Initial Determination of Child Abuse and/or Neglect Spanish DOC DCF-F-5038a-E-H Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-Review Occurred Hmong DOC DCF-F-5038a-E-S Notice of Final Determination of Child Abuse and/or Neglect and Right to Request an Appeal-Review Occurred Spanish DOC DCF-F-5035-E-H Notice of Initial Determination of Substantiated Child Maltreatment and Right to Request a Review Hmong DOC DCF-F-5035-E-S Notice of Initial Determination of Substantiated Child Maltreatment and Right to Request a Review Spanish DOC DCF-F-5048-E Notice of Decision of Appeal Termination English DOC DCF-F-5049-E Notice Decision of Appeal of Eligibility English DOC DCF-F-5052-E Licensor Guide to the Online Foster Parent Independent Living Training English DOC DCF-F-CFS0142 Affidavit English PDF DCF-F-CFS0149-E Family History Questionnaire Medical / Genetic English PDF DCF-F-CFS0149A Family History Questionnaire Medical / Genetic - Pregnancy and Delivery Information English PDF DCF-F-CFS0134 Court Report for Centralized Birth Record English PDF DCF-F-482-E Employer Confirmation of Earnings and Hours for Client English DOC DCF-F-483-E Employer Confirmation of Earnings and Hours for Provider English DOC DCF-F-5055-E Family Finding Referral and Intake English DOC DCF-F-5056-E Special Needs Adoption Program (SNAP) Referral Checklist English DOC DCF-F-5057-E Child-Specific Recruitment Consent English DOC DCF-F-5058-E Extended Relative and Non-Relative Search and Engagement Consent English DOC DCF-F-5059-E Seneca Search Request English DOC DCF-F-5057-E-H Child-Specific Recruitment Consent Hmong PDF DCF-F-5057-E-S Child-Specific Recruitment Consent Spanish PDF DCF-F-5058-E-H Extended Relative and Non-Relative Search and Engagement Consent Hmong PDF DCF-F-5058-E-S Extended Relative and Non-Relative Search and Engagement Consent Spanish PDF DCF-F-5065-E Request for Child Protective Services Background Check for Certain Purposes English WEB DCF-F-5065-E-H Request for Child Protective Services Background Check for Certain Purposes Hmong WEB DCF-F-5065-E-S Request for Child Protective Services Background Check for Certain Purposes Spanish WEB DCF-F-5070-E Public Adoptions Request for Specialized Services or Residential Care Center Placements English DOC W-9 Request for Taxpayer Identification Number and Certification English PDF DCF-F-CFS2238 Placement Checklist English DOC DCF-F-425B-E Child Care Agency Annual Summary: Certification Contract Function Only English DOC DCF-F-2976-E Wisconsin Shares Inclusion Rate Request English DOC DCF-F-CFS2316-H Infant Relinquishment - Questions About You and the Infant Hmong PDF DCF-F-CFS2316-S Infant Relinquishment - Questions About You and the Infant Spanish PDF DCF-F-2898-E 2017 DCF / DFES Worker's Compensation Coverage Application English DOC DCF-F-2899-E 2017 DCF / DFES Worker's Compensation (Declines Coverage) English DOC DCF-F-2958-E Performance Outcome Payment Claim Denial Decision Appeal Form English DOC DCF-F-5078-E Subsidized Guardianship of Children with Special Needs One time Expense Reimbursement English DOC DCF-F-5085-E Child Welfare Request for Exception - Age English DOC DCF-F-5088 Wisconsin Works Trial Employment Match Program - Employer Agreement English DOC DCF-F-5096-E Adoptee Affidavit English DOC DCF-F-5097-E Birth Parent Request for Adoptee's Identity English DOC DCF-F-5154 Health and Safety Checklist - License Exempt Program DCF 251 English PDF DCF-F-5155-E Information Required to Monitor School-Run, License-Exempt Child Care Centers English DOC DCF-F-5157-E External SPARC Sign In Authorization Request English DOC DCF-F-CFS2225-E Report to the Court on the Adoption Investigation English DOC DCF-F-2222-E Guardian Recommendation for Adoption English DOC DCF-F-5109-E YoungStar Contract English DOC DCF-F-5112-E YoungStar Request for Off-Year Services English DOC DCF-F-CFS2179-E Protective Plan English PDF DCF-F-CFS2179-E Protective Plan English DOC DCF-F-2978-E Background Information Disclosure (BID) English DOC DCF-F-2978-E-H Background Information Disclosure (BID) Hmong DOC DCF-F-2978-E-S Background Information Disclosure (BID) Spanish DOC DCF-F-CFS2179-E-H Protective Plan Hmong DOC DCF-F-CFS2179-E-H Protective Plan Hmong PDF DCF-F-CFS2179-E-S Protective Plan Spanish DOC DCF-F-CFS2179-E-S Protective Plan Spanish PDF DCF-F-5123-E Reasonable and Prudent Parent Standard Review English DOC DCF-F-5124-E Reasonable Prudent Parenting Decision Record English DOC DCF-F-2601-E Child Welfare Licensing Shelter Care Extension English DOC DCF-F-4147 Fire Safety Inspection - Shelter Cares English PDF DCF-F-4148-E Child Welfare Vehicle Safety Inspection English DOC DCF-F-5200-E Access Request - WEBi Child Care English DOC DCF-F-5199-E Access Request - WEBi Foodshare & Automated Case Directory English DOC DCF-F-5198-E Access Request - WEBi Child Support English DOC DCF-F-5197-E Access Request - WEBi BRITS English DOC DCF-F-5194-E Access Request - WEBi Employment Programs English DOC DCF-F-5212 WWP Application - User Setup Form English DOC DCF-F-5209-E Staff Record Checklist - License Exempt Child Care English PDF
