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 Sort descending Division Language Release date File type Available to order
F-02994 Remediation Survey for Child Care Centers DPH English 03/2022 HTML
F-01989S Renewal Application - Individual Certification, Spanish DPH Spanish 06/2025 PDF
F-01989 Renewal Lead Application - Individual Certification DPH English 06/2025 PDF
F-00233 Renewal Summary Letter DMS English 08/2019 Word
F-00233H Renewal Summary Letter (Hmong) DMS Hmong 08/2019 Word
F-00233S Renewal Summary Letter (Spanish) DMS Spanish 08/2019 Word
F-02610A Rental Property - Lead-Safe Homes Program Application DPH English 03/2024 PDF
F-02610AS Rental Property - Lead-Safe Homes Program Application, Spanish DPH Spanish 03/2024 PDF
F-03193 Replacement Request For Stolen FoodShare Benefits OIG English 04/2024 PDF
F-03193H Replacement Request For Stolen FoodShare Benefits, Hmong OIG Hmong 04/2024 PDF
F-03193S Replacement Request For Stolen FoodShare Benefits, Spanish OIG Spanish 04/2024 PDF
F-02642A Report a Change in Circumstance DMS English 08/2020 Word
F-02642AH Report a Change in Circumstance, Hmong DMS Hmong 08/2020 Word
F-02642AS Report a Change in Circumstance, Spanish DMS Spanish 08/2020 Word
F-05035 Report Change Name, Sex Birth Certificate Surgical Procedure DPH English 04/2005 HTML
F-00577 Report Fraud OIG English 03/2012 HTML
F-02642 Report of a Change in Circumstance to Income Maintenance Agencies DMS English 08/2020 Word
F-02642H Report of a Change in Circumstance to Income Maintenance Agencies, Hmong DMS Hmong 08/2020 Word
F-02642S Report of a Change in Circumstance to Income Maintenance Agencies, Spanish DMS Spanish 08/2020 Word
F-05021C Report of Confidential Legal Name Change DPH English 08/2024 HTML
F-05054 Report of Court Order to Amend Cause of Death on a Wisconsin Death Record DPH English 08/2024 HTML
F-62164 Report of Hours Worked - Licensed Practical Nurse / Day DQA English 07/2008 Word
F-62164 Report of Hours Worked - Licensed Practical Nurse / Day DQA English 07/2008 PDF
F-62165 Report of Hours Worked - Licensed Practical Nurse / Evening DQA English 07/2008 Word
F-62165 Report of Hours Worked - Licensed Practical Nurse / Evening DQA English 07/2008 PDF
F-62166 Report of Hours Worked - Licensed Practical Nurse / Night DQA English 07/2008 PDF
F-62166 Report of Hours Worked - Licensed Practical Nurse / Night DQA English 07/2008 Word
F-62024 Report of Hours Worked - Nurse Aide / Day DQA English 07/2008 Word
F-62024 Report of Hours Worked - Nurse Aide / Day DQA English 07/2008 PDF
F-62026 Report of Hours Worked - Nurse Aide / Evening DQA English 07/2008 PDF
F-62026 Report of Hours Worked - Nurse Aide / Evening DQA English 07/2008 Word
F-62028 Report of Hours Worked - Nurse Aide / Night DQA English 07/2008 PDF
F-62028 Report of Hours Worked - Nurse Aide / Night DQA English 07/2008 Word
F-62440 Report of Hours Worked - Other Direct Care Nurse Aide / Day DQA English 02/2009 PDF
F-62440 Report of Hours Worked - Other Direct Care Nurse Aide / Day DQA English 02/2009 Word
F-62441 Report of Hours Worked - Other Direct Care Nurse Aide / Evening DQA English 02/2009 PDF
F-62441 Report of Hours Worked - Other Direct Care Nurse Aide / Evening DQA English 02/2009 Word
F-62442 Report of Hours Worked - Other Direct Care Nurse Aide / Night DQA English 02/2009 Word
F-62442 Report of Hours Worked - Other Direct Care Nurse Aide / Night DQA English 02/2009 PDF
F-62023 Report of Hours Worked - Registered Nurse / Day DQA English 07/2008 Word
F-62023 Report of Hours Worked - Registered Nurse / Day DQA English 07/2008 PDF
F-62025 Report of Hours Worked - Registered Nurse / Evening DQA English 07/2008 Word
F-62025 Report of Hours Worked - Registered Nurse / Evening DQA English 07/2008 PDF
F-62027 Report of Hours Worked - Registered Nurse / Night DQA English 07/2008 Word
F-62027 Report of Hours Worked - Registered Nurse / Night DQA English 07/2008 PDF
F-05021 Report of Legal Name Change DPH English 08/2024 HTML
F-62470 Reportable Death Determination DQA English 01/2025 HTML
F-01977 Reportable Incident Submission DCTS English 03/2025 HTML
F-20987S Representative Designation Medicaid Community Waiver Programs, Spanish DMS Spanish 03/2017 PDF
Reproductive Health Family Planning (RHFP) Program Fiscal Review DPH 05/2025

Glossary

 
Last revised December 4, 2024