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CLTS Waiver Provider Agency Registration, F-02617 (06/2021)

Welcome to the Wisconsin Children’s Long-Term Support (CLTS) Waiver Provider Online Registration for Provider Agencies.

Thank you for your interest in delivering services for the CLTS Waiver Program. 

Registering is the first step to becoming an authorized CLTS Waiver Program provider. After completing this registration process, the Wisconsin Department of Health Services (DHS) will verify your agency's qualifications.

Once DHS has verified your qualifications and business information, your agency's information will be added to the public CLTS Provider Directory.
  • This public directory is available to families and lists all registered providers that meet initial qualifications for the CLTS Waiver Program.
  • Your agency's information will be shared with county waiver agencies (CWAs) that manage the next steps in the service authorization process. 
Do not register with this form if you are an fiscal management service (FMS) agency or sole proprietor (you do not employ staff). FMS providers must register using F-02534, and sole proprietors must register using F-02672

Do not complete the registration process if you are a direct care worker employed by a provider agency or are paid by a fiscal agent.

If you have any questions about the registration process, please email us.