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Official DHS Forms Library

Forms produced by the Wisconsin Department of Health Services are available electronically and/or for paper order. Review the "Available to Order" column below to ensure availability in paper format. If the document is available to order in a paper version, there will be a "Yes" with a link to ordering instructions. When you are searching for a document, enter the number or a portion of the title in the search box below. To narrow your search results even more, place quotation marks (" ") around search terms.

If you are looking for an informative document, visit our Informative Documents and Publications Library. If you need a file in another file format or can't find what you are looking for here, reach out to the Digital Communications Team at dhsfmorder@dhs.wisconsin.gov. You can typically expect a response within 1-2 business days.

Assigned number Title Division Language Release date Available to order
F-03044 1-2 Bed Adult Family Home (AFH) Change Reporting (Word) DMS English 06/2022 No
F-02602 1-2 Bed Adult Family Home Certification Application Request (Word) DMS English 02/2021 No
F-03274 1915(i) Housing Support Services Eligibility Evaluation and Needs Assessment (PDF) DMS English 02/2025 No
F-03274 1915(i) Housing Support Services Eligibility Evaluation and Needs Assessment (Word) DMS English 02/2025 No
F-03274A 1915(i) Housing Support Services Eligibility Evaluation and Needs Assessment Instructions (PDF) DMS English 02/2025 No
F-03278 1915(i) Housing Support Services Health and Welfare Affirmation (PDF) DMS English 02/2025 No
F-03278 1915(i) Housing Support Services Health and Welfare Affirmation (Word) DMS English 02/2025 No
F-00301 2009 Wisconsin ACT 318 High Cost Mental Health Fund Application (Word) DCTS English 08/2016 No
F-03054 2022-2023 K-12 COVID-19 Testing Program Participation (HTML) DPH English 06/2022 No
F-01781 2025–2026 (PHEP BP2) Immunization Program Full-scale Exercise After Action Report/Improvement Plan (Word) DPH English 10/2025 No
DMS-1004 2026 FoodShare Management Evaluation Review (MER) Customer Survey, English (HTML) DMS English 01/2026 No
DMS-1004S 2026 FoodShare Management Evaluation Review (MER) Customer Survey, Spanish (HTML) DMS Spanish 01/2026 No
DMS-1006 2026 Management Evaluation Review (MER) Advocate Survey (HTML) DMS English 01/2026 No
DMS-1005 2026 Management Evaluation Review (MER) Income Maintenance (IM) Staff Survey (HTML) DMS English 01/2026 No
F-01418 21-Day Monitoring Period Chart (PDF) DPH English 12/2014 No
F-01161 Abortion Certification Statements (PDF) DMS English 09/2019 No
F-01161 Abortion Certification Statements (Word) DMS English 09/2019 No
F-40117 Abortion Information Provision Certification (PDF) DPH English 02/2016 No
F-40117S Abortion Information Provision Certification, Spanish (PDF) DPH Spanish 02/2016 No
F-01991 ACCESS Application Cover Sheet - Milwaukee Enrollment Services (MilES) (PDF, 90 KB) (PDF) DMS English 02/2017 No
F-01160 Acknowledgement of Receipt of Hysterectomy Information (Word) DMS English 06/2013 No
F-01160 Acknowledgement of Receipt of Hysterectomy Information (PDF) DMS English 06/2013 No
F-01160A Acknowledgement of Receipt of Hysterectomy Information Completion Instructions (PDF) DMS English 06/2013 No
F-01160AH Acknowledgement of Receipt of Hysterectomy Information Completion Instructions, Hmong (PDF) DMS Hmong 06/2013 No
F-01160AS Acknowledgement of Receipt of Hysterectomy Information Completion Instructions, Spanish (PDF) DMS Spanish 06/2013 No
F-01160H Acknowledgement of Receipt of Hysterectomy Information, Hmong (Word) DMS Hmong 06/2013 No
F-01160H Acknowledgement of Receipt of Hysterectomy Information, Hmong (PDF) DMS Hmong 06/2013 No
F-01160S Acknowledgement of Receipt of Hysterectomy Information, Spanish (Word) DMS Spanish 06/2013 No
F-01160S Acknowledgement of Receipt of Hysterectomy Information, Spanish (PDF) DMS Spanish 06/2013 No
F-02474 Active Tuberculosis (TB) Disease Follow-up Report (PDF) DPH English 03/2019 No
F-42014 Acuity Index (PDF) DPH English 01/2016 No
F-44151 Acute and Communicable Disease Case Report (Word) DPH English 10/2025 No
F-44151 Acute and Communicable Disease Case Report (PDF) DPH English 10/2025 No
F-16004 Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits (PDF) DMS English 04/2024 No
F-16004H Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits, Hmong (PDF) DMS Hmong 04/2024 No
F-16004R Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits, Russian (PDF) DMS Russian 04/2024 No
F-16004S Add or Remove an Authorized Buyer or Alternate Payee for FoodShare Benefits, Spanish (PDF) DMS Spanish 04/2024 No
F-13046 Adjustment / Reconsideration Request (Word) DMS English 02/2025 No
F-13046 Adjustment / Reconsideration Request (PDF) DMS English 02/2025 No
F-13046A Adjustment / Reconsideration Request: Completion Instructions (PDF) DMS English 02/2025 No
F-16038 Administrative Disqualification Hearing Notice (PDF) DMS English 08/2023 No
F-16038AR Administrative Disqualification Hearing Notice, Arabic (PDF) DMS Arabic 08/2023 No
F-16038CM Administrative Disqualification Hearing Notice, Chinese (Simplified) (PDF) DMS Chinese (Simplified) 08/2023 No
F-16038G Administrative Disqualification Hearing Notice, German (PDF) DMS German 08/2023 No
F-16038H Administrative Disqualification Hearing Notice, Hmong (PDF) DMS Hmong 08/2023 No
F-16038L Administrative Disqualification Hearing Notice, Laotian (PDF) DMS Lao 08/2023 No
F-16038R Administrative Disqualification Hearing Notice, Russian (PDF) DMS Russian 08/2023 No
F-16038SO Administrative Disqualification Hearing Notice, Somali (PDF) DMS Somali 08/2023 No
F-16038S Administrative Disqualification Hearing Notice, Spanish (PDF) DMS Spanish 08/2023 No
F-25213 Admission to Caseload - Mental Health (PDF) DCTS English 12/2016 No

DHS is required under Wis. Stat. § 15.04(1) to establish and maintain a forms management program, appoint a forms officer, and establish and maintain a numbering and filing system for official forms.

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Last revised October 27, 2025