Home
Forms Library
Background disclosure form

Background disclosure form 2026

background disclosure form Preview on Page 1

See details

4.7 out of 5

31 votes

The document outlines the Background Information Disclosure form (HFS-64) required by the Wisconsin Caregiver Background Check Law. It details the information needed for employers and regulatory agencies to make informed decisions regarding employment, licensing, and residency for individuals with potential criminal backgrounds. The law prohibits certain individuals with specific convictions from being licensed or employed in caregiving roles. It also emphasizes the importance of providing accurate personal information and the consequences of failing to comply.

Here's how it works

01. Edit your background disclosure form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out the background disclosure form with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open the Background Information Disclosure form in the editor.
Begin by filling out your personal information, including your first and last name, birthdate, and address. Ensure all details are accurate.
Select the appropriate checkbox that describes your status: Employee/Contractor, Applicant for a license, Household member, or Other.
In Section A, answer questions regarding any criminal charges or convictions. If applicable, provide details such as dates and locations of incidents.
Proceed to Section B and respond to questions about any previous licensing issues or military discharge. Attach any required documents as specified.
Review all entries for accuracy before signing the form at the bottom. Your signature confirms that the information is truthful.

Start using our platform today to complete your background disclosure form online for free!

See more background disclosure form versions

We've got more versions of the background disclosure form form. Select the right background disclosure form version from the list and start editing it straight away!