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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 File type Available to order
F-80190 Travel Reimbursement Request Non-State Employee DES English 03/2026 Excel No
F-02057A Tribal ADRS Program Authorization for the Release of Confidential Information DPH English 05/2022 Word No
F-00576A Tribal Aging and Disability Resource Specialist (TADRS) Annual Budget DPH English 08/2019 Excel No
F-00576 Tribal Aging and Disability Resource Specialist (TADRS) Application DPH English 06/2022 Word No
F-03104 Tribal Aging and Disability Resource Specialist Annual Update Checklist DPH English 11/2022 Word No
F-03104 Tribal Aging and Disability Resource Specialist Annual Update Checklist DPH English 11/2022 HTML No
F-11130 Tribal and Out-of-State Federally Qualified Health Center DMS English 01/2021 Excel No
F-11129A Tribal and Out-of-State Federally Qualified Health Center Cost Report Completion Instructions DMS English 01/2021 PDF No
F-11129 Tribal and Out-of-State Federally Qualified Health Center Cost Report Forms OIG English 01/2021 Excel No
F-11130A Tribal and Out-of-State Federally Qualified Health Center, Instructions DMS English 01/2021 PDF No
F-02462 Tuberculosis (TB) Treatment Assistance Enrollment and Agreement DPH English 09/2025 PDF No
F-02463 Tuberculosis (TB) Treatment Assistance Program - Request for Reimbursement DPH English 03/2025 PDF No
F-02461 Tuberculosis (TB) Treatment Assistance Program - Special Request DPH English 10/2020 PDF No
F-00905A Tuberculosis Contact Window Treatment Initial Request for Medication DPH English 09/2021 PDF No
F-44000 Tuberculosis Disease Initial Request for Medication DPH English 11/2023 PDF No
F-00905 Tuberculosis Infection - Initial Request for Medication DPH English 12/2024 Word No
F-02163 Tuberculosis Ordering and Billing Interface (TOBI) User Security and Confidentiality Agreement DPH English 03/2025 PDF No
F-42001 Tuberculosis Suspect Case Data DPH English 04/2001 PDF No
F-00634A Types and Locations of Early Intervention Records Birth to 3 Program DMS English 02/2017 Word No
F-00727 Typical Hearing Developmental Milestones DMS English 12/2025 Word No
F-00727H Typical Hearing Developmental Milestones, Hmong DMS Hmong 12/2025 Word No
F-00727S Typical Hearing Developmental Milestones, Spanish DMS Spanish 12/2025 Word No
F-10189 Undue Hardship Bed Hold Notice DMS English 04/2017 Word No
F-10188 Undue Hardship Waiver Decision for Facility DMS English 04/2017 Word No
F-03135 Update to an EMS Service Providers Operational Plan Components Checklist DPH English 03/2023 Word No
F-02140CM Urgent Services Agreement, Chinese (Simplified) DPH Chinese (Simplified) 12/2025 Word No
F-02140H Urgent Services Agreement, Hmong DPH Hmong 12/2025 Word No
F-02140L Urgent Services Agreement, Laotian DPH Lao 12/2025 Word No
F-02140R Urgent Services Agreement, Russian DPH Russian 12/2025 Word No
F-02140SO Urgent Services Agreement, Somali DPH Somali 12/2025 Word No
F-02140S Urgent Services Agreement, Spanish DPH Spanish 12/2025 Word No
F-02140UK Urgent Services Agreement, Ukrainian DPH Ukrainian 12/2025 Word No
F-02140V Urgent Services Agreement, Vietnamese DPH Vietnamese 12/2025 Word No
F-02140 Urgent Services Enrollment Agreement DPH English 12/2025 Word No
F-02140 Urgent Services Enrollment Agreement (DocuSign) DPH English 12/2025 HTML No
F-02140AR Urgent Services Enrollment Agreement, Arabic DPH Arabic 12/2025 Word No
F-02140AR Urgent Services Enrollment Agreement, Arabic (DocuSign) DPH Arabic 12/2025 HTML No
F-02140BU Urgent Services Enrollment Agreement, Burmese DPH Burmese 12/2025 Word No
F-02140BU Urgent Services Enrollment Agreement, Burmese (DocuSign) DPH Burmese 12/2025 HTML No
F-02140CM Urgent Services Enrollment Agreement, Chinese (Simplified) (DocuSign) DPH Chinese (Simplified) 12/2025 HTML No
F-02140H Urgent Services Enrollment Agreement, Hmong (DocuSign) DPH Hmong 12/2025 HTML No
F-02140L Urgent Services Enrollment Agreement, Laotian (DocuSign) DPH Lao 12/2025 HTML No
F-02140R Urgent Services Enrollment Agreement, Russian (DocuSign) DPH Russian 12/2025 Word No
F-02140SO Urgent Services Enrollment Agreement, Somali (DocuSign) DPH Somali 12/2025 HTML No
F-02140S Urgent Services Enrollment Agreement, Spanish (DocuSign) DPH Spanish 12/2025 HTML No
F-02140UK Urgent Services Enrollment Agreement, Ukrainian (DocuSign) DPH Ukrainian 12/2025 HTML No
F-02140V Urgent Services Enrollment Agreement, Vietnamese (DocuSign) DPH Vietnamese 12/2025 HTML No
F-02995 Vaccination Community Outreach Grant Quarterly Report DPH English 03/2022 HTML No
F-44702 Vaccine Administration Record DPH English 04/2025 PDF No
F-44702H Vaccine Administration Record, Hmong DPH Hmong 04/2025 PDF 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