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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-80025A Forms / Publications Order OS English 07/2018 Word No
F-80025A Forms / Publications Order OS English 07/2018 PDF No
F-80025A-DPH Forms / Publications Requisition - Diabetes Materials DPH English 08/2022 Word No
F-20920 Formula to Determine Amount of Income Available to Pay for Room & Board in Substitute Care DMS English 03/2017 Word No
F-02493 ForwardHealth Prior Authorization Speech-Generating Device Purchase Recommendation Attachment DMS English 07/2019 Word No
F-02493 ForwardHealth Prior Authorization Speech-Generating Device Purchase Recommendation Attachment DMS English 07/2019 PDF No
F-02493 ForwardHealth Prior Authorization Speech-Generating Device Purchase Recommendation Attachment Instructions DMS English 07/2019 PDF No
F-02494 ForwardHealth Prior Authorization Speech-Generating Device Skills and Needs Profile Attachment DMS English 07/2019 Word No
F-02494 ForwardHealth Prior Authorization Speech-Generating Device Skills and Needs Profile Attachment DMS English 07/2019 PDF No
F-02494 ForwardHealth Prior Authorization Speech-Generating Device Skills and Needs Profile Attachment Instructions DMS English 07/2019 PDF No
F-01361 ForwardHealth Provider Express Enrollment Change of Address DMS English 09/2014 HTML No
F-01999 Foster Grandparent Program: State Match Funding Application DPH English 09/2019 Word No
F-02614 Fraud Prevention and Investigation Program (FPIP) Fraud Year Contact Information OIG English 02/2020 Word No
F-01261 Fraud Statement - IRIS Program DMS English 07/2018 Word No
F-22553A Free In-Service or Educational Training Request DPH English 07/2008 PDF No
F-00258 Functional Eligibility Screen - Mental Health and Substance Use Disorder Services DCTS English 03/2023 PDF No
F-00367 Functional Eligibility Screen for Children's Long-Term Support Programs (PDF, 122 KB) DMS English 12/2021 PDF No
F-00165C Funded Programs Checklist OLC English 12/2021 Word No
F-00165B Funding Relationship to DHS/DCF OLC English 12/2021 Word No
F-01068F General Pediatric Clinic - 12 Month Visit DMS English 08/2019 PDF No
F-01068F General Pediatric Clinic - 12 Month Visit DMS English 08/2019 Word No
F-01068G General Pediatric Clinic - 15 Month Visit DMS English 08/2019 PDF No
F-01068G General Pediatric Clinic - 15 Month Visit DMS English 08/2019 Word No
F-01068H General Pediatric Clinic - 18 Month Visit DMS English 08/2019 Word No
F-01068H General Pediatric Clinic - 18 Month Visit DMS English 08/2019 PDF No
F-01068i General Pediatric Clinic - 24 Month Visit DMS English 08/2019 PDF No
F-01068i General Pediatric Clinic - 24 Month Visit DMS English 08/2019 Word No
F-01068A General Pediatric Clinic - 3 to 4 Week Visit DMS English 08/2019 PDF No
F-01068A General Pediatric Clinic - 3 to 4 Week Visit DMS English 08/2019 Word No
F-01068C General Pediatric Clinic - 4 Month Visit DMS English 08/2019 Word No
F-01068C General Pediatric Clinic - 4 Month Visit DMS English 08/2019 PDF No
F-01068D General Pediatric Clinic - 6 Month Visit DMS English 08/2019 Word No
F-01068D General Pediatric Clinic - 6 Month Visit DMS English 08/2019 PDF No
F-01068B General Pediatric Clinic - 6 to 8 Week Visit DMS English 08/2019 PDF No
F-01068B General Pediatric Clinic - 6 to 8 Week Visit DMS English 08/2019 Word No
F-01068E General Pediatric Clinic - 9 Month Visit DMS English 08/2019 PDF No
F-01068E General Pediatric Clinic - 9 Month Visit DMS English 08/2019 Word No
F-01068K General Pediatric Clinic - Elementary School Visit DMS English 08/2019 Word No
F-01068K General Pediatric Clinic - Elementary School Visit DMS English 08/2019 PDF No
F-01068J General Pediatric Clinic - Preschool Visit DMS English 08/2019 PDF No
F-01068J General Pediatric Clinic - Preschool Visit DMS English 08/2019 Word No
F-01068L General Pediatric Clinic - Teenager Visit DMS English 08/2019 PDF No
F-01068L General Pediatric Clinic - Teenager Visit DMS English 08/2019 Word No
F-45021 Generally Licensed Device Inspection by Mail DPH English 03/2010 PDF No
F-45021 Generally Licensed Device Inspection by Mail DPH English 03/2010 Word No
F-10111 Good Faith Medicaid / BadgerCare Plus Certification DMS English 09/2013 PDF No
F-10111 Good Faith Medicaid / BadgerCare Plus Certification Instructions DMS English 09/2013 PDF No
F-00642 Grants Enrollment, Application & Reporting System (GEARS) Expenditure Report DES English 05/2023 Excel No
F-01212 Grievance - IRIS Program DMS English 01/2022 Word No
F-01212 Grievance - IRIS Program, French DMS French 01/2022 Word No
Last revised April 13, 2023