Notice Of Initial Placement By Appropriate Board Or Designated Agency - Wisconsin 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the case number and the date of birth of the individual in the designated fields.
3. Fill in the placement details, including the specific date of placement and the name, address, and telephone number of the placement unit.
4. Indicate whether the placement unit is an unlocked or locked unit by selecting the appropriate option.
5. Select the type of placement unit from options such as nursing facility, foster care services, or group home, ensuring you choose one that accurately reflects the situation.
6. Confirm if the individual has a developmental disability by checking the relevant box.
7. Finally, sign and print your name in the signature section, along with identifying information for the board or designated agency and date.

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