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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-02588 Financial Exploitation Tracking for Counties DPH English 04/2021 Excel No
F-80130 Financial Information DES English 08/2011 PDF No
F-80130 Financial Information, Hmong DES Hmong 08/2011 PDF No
F-80130 Financial Information, Spanish DES Spanish 08/2011 Word No
F-80130 Financial Information, Spanish DES Spanish 08/2011 PDF No
F-80130 Financial Information  DES English 08/2011 Word No
F-00407 Financial Records Request DMS English 05/2019 PDF No
F-47478 First Responder / Emergency Medical Technician Application Electronic Addition to a Roster DPH English 05/2004 HTML No
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-01293C Fiscal Employer Agent (FEA) Change Effective Date Letter DMS English 05/2023 Word No
F-00161A Flowchart of Entity Investigation and Reporting Requirements for Caregiver Misconduct and Injuries of Uknown Source DQA English 03/2020 PDF No
F-40103 FMNP Senior Eligibility Agreement DPH English 05/2023 PDF Yes
F-40103 FMNP Senior Eligibility Agreement, Hmong DPH Hmong 05/2023 PDF Yes
F-40103 FMNP Senior Eligibility Agreement, Spanish DPH Spanish 05/2023 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-02491 FoodShare Buy and Make Food Separately, Arabic DMS Arabic 05/2019 PDF No
F-02491 FoodShare Buy and Make Food Separately, Chinese DMS Chinese Mandarin 05/2019 PDF No
F-02491 FoodShare Buy and Make Food Separately, German DMS German 05/2019 PDF No
F-02491 FoodShare Buy and Make Food Separately, Hmong DMS Hmong 05/2019 PDF No
F-02491 FoodShare Buy and Make Food Separately, Laotian DMS Laotian 05/2019 PDF No
F-02491 FoodShare Buy and Make Food Separately, Russian DMS Russian 05/2019 PDF No
F-02491 FoodShare Buy and Make Food Separately, Somali DMS Somali 05/2019 PDF No
F-02491 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 11/2015 Word No
F-01256 FoodShare Employment and Training (FSET) - Discuss FSET Participation DMS English 11/2015 Word No
F-01254 FoodShare Employment and Training (FSET) - Employment Plan (EP) Appointment DMS English 11/2015 Word No
F-01252 FoodShare Employment and Training (FSET) - Initial Appointment DMS English 11/2015 Word No
F-01255 FoodShare Employment and Training (FSET) - Job Club Appointment DMS English 11/2015 Word No
F-01257 FoodShare Employment and Training (FSET) - Workshop Appointment DMS English 11/2015 Word No
F-02816 FoodShare Employment and Training (FSET) Program Annual Review DMS English 02/2023 Word No
F-00136 FoodShare Employment and Training (FSET) Program Participation Agreement DMS English 03/2019 PDF No
F-00136 FoodShare Employment and Training (FSET) Program Participation Agreement (Hmong) DMS Hmong 03/2019 PDF No
F-00136 FoodShare Employment and Training (FSET) Program Participation Agreement (Spanish) DMS Spanish 03/2019 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 02/2023 HTML No
F-02944 FoodShare Management Evaluation Review (MER) Customer Survey, Spanish DMS Spanish 02/2023 HTML No
F-16024 FoodShare Notice of Disqualification DMS English 05/2018 PDF No
F-16024 FoodShare Notice of Disqualification, Arabic DMS Arabic 05/2018 PDF No
F-16024 FoodShare Notice of Disqualification, Chinese Mandarin DMS Chinese Mandarin 05/2018 PDF No
F-16024 FoodShare Notice of Disqualification, German DMS German 05/2018 PDF No
F-16024 FoodShare Notice of Disqualification, Hmong DMS Hmong 05/2018 PDF No
F-16024 FoodShare Notice of Disqualification, Laotian DMS Laotian 05/2018 PDF No
F-16024 FoodShare Notice of Disqualification, Russian DMS Russian 05/2018 PDF No
F-16024 FoodShare Notice of Disqualification, Somali DMS Somali 05/2018 PDF No
Last revised April 13, 2023