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-11031 Prior Authorization / Psychotherapy Attachment (PA/PSYA) DMS English 07/2012 PDF No
F-11031A Prior Authorization / Psychotherapy Attachment (PA/PSYA) Completion Instructions DMS English 10/2008 PDF No
F-02567 Prior Authorization / Residential Substance Use Disorder Treatment Attachment (PA/RSUD) DMS English 02/2023 PDF No
F-02567 Prior Authorization / Residential Substance Use Disorder Treatment Attachment (PA/RSUD) DMS English 02/2023 Word No
F-02567A Prior Authorization / Residential Substance Use Disorder Treatment Attachment (PA/RSUD), Instructions DMS English 02/2023 PDF No
F-11039 Prior Authorization / Spell of Illness Attachment (PA/SOIA) DMS English 10/2015 PDF No
F-11039 Prior Authorization / Spell of Illness Attachment (PA/SOIA) DMS English 10/2015 Word No
F-11039A Prior Authorization / Spell of Illness Attachment (PA/SOIA): Completion Instructions DMS English 10/2015 PDF No
F-11032 Prior Authorization / Substance Abuse Attachment (PA/SAA) DMS English 07/2012 Word No
F-11032 Prior Authorization / Substance Abuse Attachment (PA/SAA) DMS English 07/2012 PDF No
F-11032A Prior Authorization / Substance Abuse Attachment (PA/SAA) Completion Instructions DMS English 10/2008 PDF No
F-11037 Prior Authorization / Substance Abuse Day Treatment Attachment (PA/SADTA) DMS English 07/2012 PDF No
F-11037 Prior Authorization / Substance Abuse Day Treatment Attachment (PA/SADTA) DMS English 07/2012 Word No
F-11037A Prior Authorization / Substance Abuse Day Treatment Attachment (PA/SADTA): Completion Instructions DMS English 07/2012 PDF No
F-11008 Prior Authorization / Therapy Attachment (PA/TA) DMS English 04/2025 PDF No
F-11008 Prior Authorization / Therapy Attachment (PA/TA) DMS English 04/2025 Word No
F-11051 Prior Authorization / Vision Services Attachment (PA/VA) DMS English 10/2020 Word No
F-11051 Prior Authorization / Vision Services Attachment (PA/VA) DMS English 10/2020 PDF No
F-11051A Prior Authorization / Vision Services Attachment (PA/VA), Instructions DMS English 10/2020 PDF No
F-11042 Prior Authorization Amendment Request DMS English 07/2012 PDF No
F-11042 Prior Authorization Amendment Request DMS English 07/2012 Word No
F-11042A Prior Authorization Amendment Request Completion Instructions DMS English 07/2012 PDF No
F-11035 Prior Authorization Dental Request Form (PA/DRF) DMS English 06/2024 PDF No
F-11035 Prior Authorization Dental Request Form (PA/DRF) DMS English 06/2024 Word No
F-11035A Prior Authorization Dental Request Form (PA/DRF) Instructions DMS English 06/2024 PDF No
F-00163 Prior Authorization Drug Attachment for Anti-Obesity Drugs DMS English 07/2024 PDF No
F-00163 Prior Authorization Drug Attachment for Anti-Obesity Drugs DMS English 07/2024 Word No
F-00163A Prior Authorization Drug Attachment for Anti-Obesity Drugs Instructions DMS English 07/2024 PDF No
F-00194 Prior Authorization Drug Attachment for Antiemetics, Cannabinoids DMS English 07/2021 Word No
F-00194 Prior Authorization Drug Attachment for Antiemetics, Cannabinoids DMS English 07/2021 PDF No
F-00194A Prior Authorization Drug Attachment for Antiemetics, Cannabinoids, Instructions DMS English 07/2021 PDF No
F-00556 Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger DMS English 01/2018 PDF No
F-00556 Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger DMS English 01/2018 Word No
F-00556A Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger Instructions DMS English 01/2018 PDF No
F-11304 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Ankylosing Spondylitis DMS English 01/2025 PDF No
F-11304 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Ankylosing Spondylitis DMS English 01/2025 Word No
F-01950 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Crohn's Disease and Ulcerative Colitis DMS English 01/2025 Word No
F-01950 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Crohn's Disease and Ulcerative Colitis DMS English 01/2025 PDF No
F-01952 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis DMS English 01/2025 Word No
F-01952 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis DMS English 01/2025 PDF No
F-01952A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis Instructions DMS English 01/2025 PDF No
F-11304A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Ankylosing Spondylitis Instructions DMS English 01/2025 PDF No
F-01950A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Crohn’s Disease and Ulcerative Colitis Instructions DMS English 01/2025 PDF No
F-03174 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa DMS English 01/2025 Word No
F-03174 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa DMS English 01/2025 PDF No
F-03174A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa Instructions DMS English 01/2025 PDF No
F-11306 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Psoriasis DMS English 01/2025 Word No
F-11306 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Psoriasis DMS English 01/2025 PDF No
F-11306A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Psoriasis Instructions DMS English 01/2025 PDF No
F-01951 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA), and Psoriatic Arthritis DMS English 01/2025 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.

Glossary

 
Last revised December 4, 2024