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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-02646 COVID-19 Isolation Site Registration DPH English 04/2020 PDF No
F-02646S COVID-19 Isolation Site Registration, Spanish DPH Spanish 04/2020 PDF No
F-02658 COVID-19 Testing: Staff Consent DQA English 09/2020 Word No
F-02768 COVID-19 Wasted Vaccine Record DPH English 01/2021 PDF No
F-02665 COVID-19: Assisted Living Change Worksheet DQA English 05/2020 Word No
F-02669 COVID-19: Provider Self-Assessment Worksheet DQA English 05/2020 Word No
F-47463K Critical Care and Specialty Care Operational Plan Components DPH English 09/2022 Word No
F-03011A CRS Documentation Oversight Feedback Report Survey DCTS English 04/2022 HTML No
F-03011 CRS Monitoring Process Feedback Report Survey DCTS English 04/2022 HTML No
F-45020 Cumulative Occupational Exposure History DPH English 08/2003 PDF No
F-01812D Current Occupancy Test Worksheet for Billing Medicaid Bed-Hold Days DMS English 10/2016 Word No
F-00165D Customer Service Population Analysis (CSPA) Data Chart OLC English 12/2021 Word No
F-00982 Data Update Information, Wisconsin Cancer Reporting System (WCRS) DPH English 03/2021 Word No
F-03045 DBS Program Orientation Follow-Up DPH English 06/2022 HTML No
F-21276 DCTS Annual Grant/Contract Application DCTS English 12/2022 Word No
F-21276C DCTS Annual Grant/Contract Application: Condensed DCTS English 12/2022 Word No
F-20389 DCTS Program Performance Report DCTS English 09/2016 Word No
F-01601 DCTS Summary Line Item Budget DCTS English 12/2024 Excel No
F-01601C DCTS Summary Line item Budget: Condensed DCTS English 03/2025 Excel No
F-05280 Death Certificate Application DPH English 06/2025 PDF No
F-05280S Death Certificate Application, Spanish DPH Spanish 06/2025 PDF No
F-00232D Decision Letter, Decision Reversed DMS English 06/2020 Word No
F-00232DAR Decision Letter, Decision Reversed, Arabic DMS Arabic 06/2020 Word No
F-00232DCM Decision Letter, Decision Reversed, Chinese (Simplified) DMS Chinese (Simplified) 06/2020 Word No
F-00232DH Decision Letter, Decision Reversed, Hmong DMS Hmong 06/2020 Word No
F-00232DL Decision Letter, Decision Reversed, Laotian DMS Lao 06/2020 Word No
F-00232DSE Decision Letter, Decision Reversed, Serbo-Croatian DMS Serbo-Croatian 06/2020 Word No
F-00232DSO Decision Letter, Decision Reversed, Somali DMS Somali 06/2020 Word No
F-00232DS Decision Letter, Decision Reversed, Spanish DMS Spanish 06/2020 Word No
F-00232E Decision Letter: Decision Upheld DMS English 06/2020 Word No
F-00232EAR Decision Letter: Decision Upheld, Arabic DMS Arabic 06/2020 Word No
F-00232ECM Decision Letter: Decision Upheld, Chinese (Simplified) DMS Chinese (Simplified) 06/2020 Word No
F-00232EH Decision Letter: Decision Upheld, Hmong DMS Hmong 06/2020 Word No
F-00232EL Decision Letter: Decision Upheld, Laotian DMS Lao 06/2020 Word No
F-00232ESE Decision Letter: Decision Upheld, Serbo-Croatian DMS Serbo-Croatian 06/2020 Word No
F-00232ESO Decision Letter: Decision Upheld, Somali DMS Somali 06/2020 Word No
F-00232ES Decision Letter: Decision Upheld, Spanish DMS Spanish 06/2020 Word No
F-01182 Declaration of Supervision for Nonbilling Providers DMS English 06/2025 PDF No
F-01182 Declaration of Supervision for Nonbilling Providers DMS English 06/2025 Word No
F-20919D Declaration Regarding Transfer of Resources, Annuity Ownership, and Home Equity for Long-Term Care Medicaid DMS English 03/2025 PDF No
F-05064 Delayed Marriage Court Order DPH English 05/2007 HTML No
F-02889 Dementia Knowledge Assessment Tool DPH English 09/2021 Word No
F-02889A Dementia Knowledge Assessment Tool Answer Key and Instructions DPH English 09/2021 PDF No
F-02870 Demographic Assessment for Communities, Boards, Workgroups, and Councils DPH English 08/2021 HTML No
F-82002 Denial of Government Access to Health Care Records OLC English 07/2008 PDF No
F-82003 Denial of Researcher Access To Health Care Records OLC English 07/2006 PDF No
F-21150 Department of Health Services Notification Regarding Need for Independent Investigation Due to Conflict of Interest with APS Report DPH English 04/2025 PDF No
F-00047 Designated Asbestos Coordinator Notification DPH English 08/2025 HTML No
F-00889 Designation of Confidential and Proprietary Information - Managed LTC Business Plan DMS English 08/2022 Word No
F-00889 Designation of Confidential and Proprietary Information - Managed LTC Business Plan DMS English 08/2022 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.

Glossary

 
Last revised October 27, 2025