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This document is a decision from the Division of Hearings and Appeals of the State of Wisconsin regarding a petition to review a decision made by the Milwaukee County Department of Human Services
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01
Obtain a copy of the DHA-15 (R10/97) form.
02
Read the instructions carefully before starting to fill out the form.
03
Fill in your personal details, including your name, address, and contact information in the designated sections.
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Provide the required identification details as requested on the form.
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Answer any specific questions related to the application thoroughly.
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Double-check all entered information for accuracy and completeness.
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Sign and date the form at the designated area.
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Submit the completed form along with any required supporting documents to the appropriate authority.

Who needs DHA-15 (R10/97)?

01
Individuals applying for specific services from the DHA.
02
Persons seeking health-related matters that require official documentation.
03
Residents needing to provide evidence for DHA-related applications.
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DHA-15 (R10/97) is a form used in the United States to report certain information related to the Department of Health and Human Services (HHS). It is part of regulatory requirements to ensure the compliance and monitoring of services.
Organizations that receive funding or are involved in programs overseen by HHS are required to file DHA-15 (R10/97). This includes healthcare providers, service organizations, and other entities that participate in HHS programs.
To fill out DHA-15 (R10/97), you should follow the instructions provided with the form carefully, ensuring all required fields are completed with accurate information about your organization, services provided, and any financial data required.
The purpose of DHA-15 (R10/97) is to collect essential data to help HHS monitor and evaluate the effectiveness of its programs and ensure compliance with federal regulations.
The information that must be reported on DHA-15 (R10/97) includes organizational details, program participation, financial information, and any other data necessary to assess compliance and program impact.
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