Skip to main content

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-62674 Home Health Agency License Application DQA English 08/2023 Word No
F-62658 Home Health Agency Program Evaluation Review Worksheet DHS 133.07(3) DQA English 04/2009 Word No
F-62658 Home Health Agency Program Evaluation Review Worksheet DHS 133.07(3) DQA English 04/2009 PDF No
F-01407 Home Visit Checklist DPH English 09/2024 PDF No
F-01407S Home Visit Checklist, Spanish DPH Spanish 09/2024 PDF No
F-03077 Home Walkthrough Checklist DPH English 06/2023 PDF No
F-62236 Hospice Clinical Record Review DQA English 01/2024 Word No
F-62287 Hospice Complaint Report DQA English 09/2025 Word No
F-62287H Hospice Complaint Report, Hmong DQA Hmong 09/2025 Word No
F-62287S Hospice Complaint Report, Spanish DQA Spanish 09/2025 Word No
F-62232 Hospice Contracts and Agreements Review DQA English 01/2024 Word No
F-62641 Hospice Inpatient Care DQA English 03/2024 Word No
F-62322 Hospice Inpatient Clinical Record Review - Interviews DQA English 03/2024 Word No
F-62062 Hospice License Application DQA English 10/2025 Word No
F-62294 Hospice Multiple Location Questionnaire DQA English 09/2024 Word No
F-62316 Hospice Patient Rights DQA English 10/2024 Word No
F-62233 Hospice Personnel Record Review DQA English 01/2024 Word No
F-62318 Hospice Quality Assessment and Performance Improvement Review DQA English 01/2024 PDF No
F-62318 Hospice Quality Assessment and Performance Improvement Review DQA English 01/2024 Word No
F-62320 Hospice Survey Information DQA English 03/2024 Word No
F-62319 Hospice Volunteer Program Review DQA English 01/2024 Word No
F-02527 Hospital (DHS 124), Home Health Agency (DHS 133), Hospice (DHS 131), Personal Care Agency (DHS 106), and Adult Day Care Center (DHS 105) DQA English 11/2022 Word No
F-62092 Hospital Certificate of Approval Application DQA English 03/2024 Word No
F-44725 Hospital/Clinic Supplement - Provider Participation Agreement DPH English 05/2019 Word No
F-22018 HSRS Long-Term Support Module - Module Type A DMS English 03/2017 Word No
F-22018 HSRS Long-Term Support Module - Module Type A DMS English 03/2017 PDF No
F-22018I HSRS Long-Term Support Module Desk Card DES English 03/2024 PDF No
F-22540 Human Service Revenue Reporting - Expenditures by Revenue Source for Human Service Programs OPIB English 01/2016 HTML No
F-22540A Human Service Revenue Reporting - Expenditures by Revenue Source for Human Service Programs Worksheet OS English 04/2013 Excel No
F-01570 Ice Arena Equipment Maintenance Log DPH English 06/2015 Word No
F-01572 Ice Arena Log of Pollutant Exceedance DPH English 06/2015 Word No
F-00195 IDEA (Individuals with Disabilities Education Act) State Complaint - WI Birth to 3 Program DMS English 12/2009 Word No
F-01831 In-Home Lead Poisoning Prevention Education Program--Home Visitor Documentation DPH English 09/2016 PDF No
F-00390 Incident Report - Community Recovery Services (CRS) DCTS English 08/2016 Word No
F-00390 Incident Report - Community Recovery Services (CRS), Instructions DCTS English 08/2016 PDF No
F-22541 Incident Report - IRIS DMS English 07/2020 PDF No
F-22541 Incident Report - IRIS DMS English 07/2020 Word No
F-20445 Individual Service Plan - Children’s Long-Term Support Programs DMS English 09/2022 Word No
F-20445 Individual Service Plan - Children’s Long-Term Support Programs DMS English 09/2022 PDF No
F-20445H Individual Service Plan - Children’s Long-Term Support Programs, Hmong DMS Hmong 09/2022 Word No
F-20445H Individual Service Plan - Children’s Long-Term Support Programs, Hmong DMS Hmong 09/2022 PDF No
F-20445I Individual Service Plan - Children’s Long-Term Support Programs, Instructions DMS English 09/2022 PDF No
F-20445S Individual Service Plan - Children’s Long-Term Support Programs, Spanish DMS Spanish 09/2022 Word No
F-20445S Individual Service Plan - Children’s Long-Term Support Programs, Spanish DMS Spanish 09/2022 PDF No
F-00202 Individual Service Plan - Community Recovery Services (CRS) DCTS English 08/2016 Word No
F-20445A Individual Service Plan - Outcomes - Children’s Long-Term Support Programs DMS English 05/2022 Word No
F-20445A Individual Service Plan: Outcomes, Children’s Long-Term Support Programs DMS English 05/2022 PDF No
F-20445AH Individual Service Plan: Outcomes, Children’s Long-Term Support Programs, Hmong DMS Hmong 05/2022 Word No
F-20445AH Individual Service Plan: Outcomes, Children’s Long-Term Support Programs, Hmong DMS Hmong 05/2022 PDF No
F-20445AS Individual Service Plan: Outcomes, Children’s Long-Term Support Programs, Spanish DMS Spanish 05/2022 Word 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