Wisconsin Code § 48.257

Petition to initiate a procedure to waive parental consent prior to a minor’s abortion
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(1) A petition to initiate a proceeding under s. 48.375 (7) shall be entitled,
“In the interest of ‘Jane Doe’, a person under the age of 18”, and
shall set forth with specificity:
(a) The name “Jane Doe” and the minor’s date of birth.
(b) A statement that the minor is pregnant and the estimated
gestational age of the fetus at the time that the petition is filed,
and a statement that the minor is seeking an abortion.
(c) The name and address of the person who intends to perform or induce the abortion, if known. If that person is not
known, the name and address of the clinic or other medical facility that intends to perform or induce the abortion, if known.
(d) A request for waiver of the parental consent requirement
under s. 48.375 (4).
(e) A statement alleging that the minor is mature and well-informed enough to make her own decision on whether or not to
have an abortion and facts sufficient to establish that the minor is
mature enough and well-informed enough to make her own
decision.
(f) A statement alleging that, if the circuit court does not find
that the minor is mature enough and well-informed enough to
make her own decision, the circuit court should find that having
an abortion is in the minor’s best interest and facts sufficient to
establish that an abortion is in the minor’s best interest.
(g) A statement acknowledging that the minor has been fully
informed of the risks and consequences of abortion and the risks
and consequences of carrying the pregnancy to term.
(h) If the minor is not represented by counsel, the place where
and the manner in which the minor wishes to be notified of proceedings under s. 48.375 (7) until appointment of counsel under
s. 48.375 (7) (a) 1. If the petition is filed by a member of the
clergy on behalf of the minor, the place where and manner in
which the member of the clergy wishes to be notified of proceedings under s. 48.375 (7).
(2) The director of state courts shall provide simplified forms
for use in filing a petition under this section to the clerk of circuit
court in each county.
(3) The minor who is seeking the abortion shall sign the
name “Jane Doe” on the petition to initiate a proceeding under s.
48.375 (7). No other person may be required to sign the petition.
(4) The clerk of circuit court shall give a copy of the petition
to the minor or to the member of the clergy who files a petition on
behalf of the minor, if any.
(5) The minor, or the intake worker under s. 48.067 (7m) ,
shall file the completed petition under this section with the clerk
of circuit court.
(6) No filing fee may be charged for a petition under this
section.

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