Wisconsin department of licensure
[DOCX File]Community-Based Residential Facility - New …
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DEPARTMENT OF HEALTH SERVICESSTATE OF WISCONSIN. Division of Quality Assurance. F-02109D (05/2017) F-62416 (xx/xxxx) STATE OF WISCONSIN Wis. Admin. Code ch. DHS 83. Page 1 of 3 . COMMUNITY-BASED RESIDENTIAL FACILITY (CBRF) NEW PROVIDER LICENSURE . APPLICATION . CHECKLIST. Name – Facility
[DOCX File]Wisconsin Department of Agriculture, Trade and …
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Wisconsin Department of Agriculture, Trade and Consumer Protection (DATCP) Veterinary Examining Board (VEB) 2811 Agriculture Drive, PO Box 8911, Madison, WI 53708-8911. Phone: (608) 224-4353 DATCPVEB@wisconsin.gov
[DOC File]Relative Caregiver Licensing Decision
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Refusal of foster care licensure (only applicable to providers approved for Kinship Care prior to 1/1/2010) Explanation of licensing decision: IV. Background Information as Specified in s.48.57(3m) and 48.57(3n), Wisconsin Statutes V.
[DOCX File]Background Information Disclosure (BID)
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This form is required under the provisions of Wis. Stat. § 48.685 and Wis. Admin. Code § DCF 12.03. Pursuant to Wis. Stat. § 48.685 and Wis. Admin. Code § DCF 12.03, this form must be completed prior to licensure, employment or non-client residency and is only valid for 120 days.
Training, Experience and Preceptor Attestation - D
State Licensure. A copy of license to practice medicine in Wisconsin is attached. Certification (attach copy of current certificate) Specialty Board Category Month and Year Certified Note: Items 4-8 do not need to be completed when using Board Certification to meet Wis. Admin. Code DHS 157 Subchapter VI training and experience requirements.
[DOCX File]Adult Family Home - Wisconsin Department of …
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An onsite licensure visit is completed by department staff to determine compliance with Wisconsin licensing requirements. At that time, facilities may also choose to be reviewed for compliance with Home and Community-Based Services standards set by The Centers for Medicare & Medicaid Services.
[DOC File]Licensure Program Guidelines for Wisconsin …
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Licensure Program Guidelines for Wisconsin Institutions. of Higher Education and Alternative Programs MIDDLE CHILDHOOD-EARLY ADOLESCENCE (72) (MC-EA = Age 6 through Age 12 or 13) EARLY ADOLESCENCE - ADOLESCENCE (73) (EA-A = Age 10 through Age 21) Specific Learning Disabilities (811) Revised: December, 2005
[DOCX File]Nursery Application - Wisconsin Department of …
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If you have questions or concerns about nursery licensure, you may contact the License/Permit Program staff via email at DATCPNursery@wisconsin.gov , or call (608) 224-4574.
[DOC File]Wisconsin - US Department of Education
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Wisconsin’s highly objective uniform state standards of evaluation (HOUSSE) through consistent program approval monitoring, licensing requirements, and annual licensure audits provide assurances that Wisconsin’s veteran elementary and secondary teachers have content knowledge in the core academic subjects in which they are licensed and ...
[DOC File]PI-1612 Institutional Endorsement and Assurances
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Wisconsin Department of Public Instruction. INSTITUTIONAL ENDORSEMENT AND ASSURANCES—TEACHER. PI-1612-T (Rev. 06-17) ... Yes—The educator met the required GPA of 3.0 or higher in the licensure area(s). ... State of Wisconsin
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