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Data Collection (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 form, enter the number or a portion of the title in the search box below.

Assigned Number Title Division Language Release Date File Type Available to Order
F-47477 First Responder / Emergency Medical Technician Certificate / License DPH English 02/2006 HTML No
F-47181 First Responder Certification Card DPH English 08/2010 HTML No
F-47463A First Responder Operational Plan Components DPH English 01/2012 PDF No
F-02813 First Responder Training Access Request DCTS English 06/2021 HTML No
F-02814 First Responder Training Evaluation DCTS English 06/2021 HTML No
F-00152A Fiscal Analysis Details for Pay Over the Medicaid Fee-for-Service Rate Notification DMS English 02/2017 Excel No
F-40103 FMNP Senior Eligibility Agreement DPH English 07/2023 PDF Yes
F-40103H FMNP Senior Eligibility Agreement, Hmong DPH Hmong 07/2023 PDF Yes
F-40103S FMNP Senior Eligibility Agreement, Spanish DPH Spanish 07/2023 PDF Yes
F-16106 FoodShare Affidavit of Lost Income or Costs from a Disaster DMS English 08/2016 Word No
F-02491 FoodShare Buy and Make Food Separately DMS English 05/2019 PDF No
F-02491AR FoodShare Buy and Make Food Separately, Arabic DMS Arabic 05/2019 PDF No
F-02491CM FoodShare Buy and Make Food Separately, Chinese DMS Chinese Mandarin 05/2019 PDF No
F-02491G FoodShare Buy and Make Food Separately, German DMS German 05/2019 PDF No
F-02491H FoodShare Buy and Make Food Separately, Hmong DMS Hmong 05/2019 PDF No
F-02491L FoodShare Buy and Make Food Separately, Laotian DMS Laotian 05/2019 PDF No
F-02491R FoodShare Buy and Make Food Separately, Russian DMS Russian 05/2019 PDF No
F-02491SO FoodShare Buy and Make Food Separately, Somali DMS Somali 05/2019 PDF No
F-02491S FoodShare Buy and Make Food Separately, Spanish DMS Spanish 05/2019 PDF No
F-01253 FoodShare Employment and Training (FSET) - Appointment Final Notice DMS English 07/2023 Word No
F-01256 FoodShare Employment and Training (FSET) - Discuss FSET Participation DMS English 07/2023 Word No
F-01254 FoodShare Employment and Training (FSET) - Employment Plan (EP) Appointment DMS English 07/2023 Word No
F-01252 FoodShare Employment and Training (FSET) - Initial Appointment DMS English 07/2023 Word No
F-01255 FoodShare Employment and Training (FSET) - Job Club Appointment DMS English 07/2023 Word No
F-01257 FoodShare Employment and Training (FSET) - Workshop Appointment DMS English 07/2023 Word No
F-00136 FoodShare Employment and Training (FSET) Program Participation Agreement DMS English 07/2023 PDF No
F-00136H FoodShare Employment and Training (FSET) Program Participation Agreement (Hmong) DMS Hmong 07/2023 PDF No
F-00136S FoodShare Employment and Training (FSET) Program Participation Agreement (Spanish) DMS Spanish 07/2023 PDF No
F-02915 FoodShare Employment and Training (FSET) Program Quarterly and Quality Assurance Report DMS English 03/2022 Word No
F-02944 FoodShare Management Evaluation Review (MER) Customer Survey DMS English 02/2024 HTML No
F-02944S FoodShare Management Evaluation Review (MER) Customer Survey, Spanish DMS Spanish 02/2024 HTML No
F-16024 FoodShare Notice of Disqualification DMS English 07/2023 PDF No
F-16024AR FoodShare Notice of Disqualification, Arabic DMS Arabic 07/2023 PDF No
F-16024CM FoodShare Notice of Disqualification, Chinese Mandarin DMS Chinese Mandarin 07/2023 PDF No
F-16024G FoodShare Notice of Disqualification, German DMS German 05/2018 PDF No
F-16024H FoodShare Notice of Disqualification, Hmong DMS Hmong 07/2023 PDF No
F-16024L FoodShare Notice of Disqualification, Laotian DMS Laotian 05/2018 PDF No
F-16024R FoodShare Notice of Disqualification, Russian DMS Russian 07/2023 PDF No
F-16024SO FoodShare Notice of Disqualification, Somali DMS Somali 07/2023 PDF No
F-16024S FoodShare Notice of Disqualification, Spanish DMS Spanish 07/2023 PDF No
F-02866 FoodShare Request for Proof DMS English 09/2021 Word No
F-02866H FoodShare Request for Proof, Hmong DMS Hmong 09/2021 Word No
F-02866S FoodShare Request for Proof, Spanish DMS Spanish 09/2021 Word No
F-16076 FoodShare Six-Month Report DMS English 10/2023 Word No
F-16076A FoodShare Six-Month Report Instructions DMS English 10/2023 Word No
F-16076AH FoodShare Six-Month Report Instructions, Hmong DMS Hmong 10/2023 Word No
F-16076AS FoodShare Six-Month Report Instructions, Spanish DMS Spanish 10/2023 Word No
F-16076H FoodShare Six-Month Report, Hmong DMS Hmong 10/2023 Word No
F-16076S FoodShare Six-Month Report, Spanish DMS Spanish 10/2023 Word No
F-16066 FoodShare Wisconsin Income Change Report DMS English 10/2023 PDF No
Last revised December 8, 2023