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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-13159 Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Restriction Request DMS English 08/2020 PDF No
F-13160 Wisconsin Chronic Disease Program (WCDP) HIPAA Privacy Revocation of Authorization DMS English 08/2020 PDF No
F-01146 Wisconsin Chronic Disease Program Provider Data Sheet DMS English 02/2009 PDF No
F-01186 Wisconsin Chronic Renal Disease Program Application DMS English 09/2019 PDF No
F-01186A Wisconsin Chronic Renal Disease Program Application Instructions DMS English 09/2019 PDF No
F-01186AH Wisconsin Chronic Renal Disease Program Application Instructions, Hmong DMS Hmong 09/2019 PDF No
F-01186AS Wisconsin Chronic Renal Disease Program Application Instructions, Spanish DMS Spanish 09/2019 PDF No
F-01186H Wisconsin Chronic Renal Disease Program Application, Hmong DMS Hmong 09/2019 PDF No
F-01186S Wisconsin Chronic Renal Disease Program Application, Spanish DMS Spanish 09/2019 PDF No
F-01189 Wisconsin Chronic Renal Disease Program Financial Need Statement DMS English 05/2025 PDF No
F-01189A Wisconsin Chronic Renal Disease Program Financial Need Statement Instructions DMS English 05/2025 PDF No
F-01189AH Wisconsin Chronic Renal Disease Program Financial Need Statement Instructions, Hmong DMS Hmong 05/2025 PDF No
F-01189AS Wisconsin Chronic Renal Disease Program Financial Need Statement Instructions, Spanish DMS Spanish 05/2025 PDF No
F-01189H Wisconsin Chronic Renal Disease Program Financial Need Statement, Hmong DMS Hmong 05/2025 PDF No
F-01189S Wisconsin Chronic Renal Disease Program Financial Need Statement, Spanish DMS Spanish 05/2025 PDF No
F-01143 Wisconsin Chronic Renal Disease Program Residency and Health Care Benefits Verification DMS English 05/2025 PDF No
F-01143H Wisconsin Chronic Renal Disease Program Residency and Health Care Benefits Verification, Hmong DMS Hmong 05/2025 PDF No
F-01143S Wisconsin Chronic Renal Disease Program Residency and Health Care Benefits Verification, Spanish DMS Spanish 05/2025 PDF No
F-03358 Wisconsin Civil Money Penalty Reinvestment Program (CMPRP) Application DQA English 08/2025 HTML No
F-00154 Wisconsin Consultative Examination Inquiry DMS English 06/2019 Word No
F-03091 Wisconsin Coverdell Stroke Community Partner Agreement DPH English 09/2024 PDF No
F-03253 Wisconsin Coverdell Stroke Education Materials DPH English 11/2023 HTML No
F-02700 Wisconsin COVID-19 Patient Information DPH English 07/2020 PDF No
F-00123 Wisconsin Declaration of Domestic Partnership Application DPH English 12/2023 PDF No
F-00123S Wisconsin Declaration of Domestic Partnership Application, Spanish DPH Spanish 01/2024 PDF No
F-05282 Wisconsin Divorce Certificate Application DPH English 12/2023 PDF No
F-05282S Wisconsin Divorce Certificate Application, Spanish DPH Spanish 01/2024 PDF No
F-02051 Wisconsin Donor Registry Enrollment DPH English 09/2023 PDF No
F-02051S Wisconsin Donor Registry Enrollment, Spanish DPH Spanish 09/2023 PDF No
F-43026 Wisconsin Donor Registry User Access Request DPH English 10/2023 Word No
F-03176 Wisconsin Electronic Disease Surveillance System (WEDSS) User Security and Confidentiality Agreement DPH English 06/2023 PDF No
F-40309A Wisconsin Emergency Assistance Volunteer Registry (WEAVR) Administrative Access User Security and Confidentiality Agreement DPH English 07/2008 PDF No
F-40309 Wisconsin Emergency Assistance Volunteer Registry (WEAVR) Administrative Access User Security and Confidentiality Policy DPH English 07/2008 PDF No
F-02741 Wisconsin Emergency Assistance Volunteer Registry (WEAVR) Staffing Request DPH English 06/2023 Word No
F-01933 Wisconsin EMS Continuing Education Record Emergency Medical Technician Refresher Requirements DPH English 08/2025 Word No
F-01934 Wisconsin EMS First Responder Training Record - First Responder Refresher Requirements DPH English 02/2019 PDF No
F-01935 Wisconsin EMS First Responder Training Record - NCCP First Responder Refresher Requirements DPH English 03/2023 PDF No
F-01938 Wisconsin EMS Paramedic Training Record - NCCP Paramedic Refresher Requirements DPH English 03/2023 PDF No
F-01955 Wisconsin EMS Training Record Critical Care Paramedic Refresher Record DPH English 03/2023 PDF No
F-01954 Wisconsin EMS Training Record NCCP AEMT Refresher Requirements DPH English 03/2023 PDF No
F-02268 Wisconsin Family Caregiver Program Data DPH English 06/2018 Excel No
F-02519 Wisconsin Family Caregiver Support Programs Caregiver Needs Assessment DPH English 11/2022 Word No
F-02519S Wisconsin Family Caregiver Support Programs Caregiver Needs Assessment, Spanish DPH Spanish 11/2022 Word No
F-16019 Wisconsin FoodShare Application DMS English 10/2024 PDF Yes
F-16019AR Wisconsin FoodShare Application, Arabic DMS Arabic 10/2024 PDF No
F-16019BU Wisconsin FoodShare Application, Burmese DMS Burmese 10/2024 PDF No
F-16019CM Wisconsin FoodShare Application, Chinese (Simplified) DMS Chinese (Simplified) 10/2024 PDF No
F-16019DA Wisconsin FoodShare Application, Dari DMS Dari (Afghan Persian) 10/2024 PDF No
F-16019H Wisconsin FoodShare Application, Hmong DMS Hmong 10/2024 PDF No
F-16019L Wisconsin FoodShare Application, Laotian DMS Laotian 10/2024 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