Department of Health and Human Services
 

Adult Protective Services Referral Form

Adult Protective Services Referral Form

Our Adult Protective Services unit investigates allegations of abuse, neglect, financial exploitation and self-neglect. If you are concerned about the safety of an adult in Milwaukee County, please complete this referral form and the information will be reviewed by our staff. The assigned investigator will contact you if further information is needed.

Your Name:
Phone:
Email: 
 
*Name of Individual You Are Concerned About:
Date of Birth:
Street Address:
City:
 
*Zip:
Phone: 

 
Please describe the situation and the concerns you have for this individual's safety. (Provide as much detail as possible.)

 

MILWAUKEE COUNTY DEPARTMENT OF HEALTH & HUMAN SERVICES

1220 W. Vliet St.

Suite 301

Milwaukee, Wisconsin 53205

Our Vision

Together, creating healthy communities.

Our Mission

Empowering safe, healthy, meaningful lives.

Our Values

Partnership, Respect, Integrity, 

Diversity, Excellence

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