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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 Sort descending Division Language Release Date File Type Available to Order
F-21076 Informed Consent – Children's Long-Term Support Functional Screen DMS English 03/2021 Word
F-21076 Informed Consent – Children's Long-Term Support Functional Screen, Karen DMS Karen 03/2021 PDF
F-21076 Informed Consent – Children's Long-Term Support Functional Screen, Rohingya DMS Rohingya 03/2021 Word
F-21076 Informed Consent – Children's Long-Term Support Functional Screen, Somali DMS Somali 03/2021 Word
F-02031 Initial Application - Individual Lead Disciplines, Spanish DPH Spanish 03/2023 PDF
F-03082C Initial Certification Application for Branch Office or School Branch Office DQA English 08/2022 Word
F-03082F Initial Certification Application for DHS 75.59 Opioid Treatment Program (OTP) Medication Unit, Mobile Medication Unit, or Mobile OTP Unit DQA English 11/2022 Word
F-03082 Initial Certification or Change of Ownership Application for DHS 75.14 and DHS 75.15 Service Certification DQA English 08/2022 Word
F-03082A Initial Certification or Change of Ownership Application for DHS 75.49, DHS 75.50, DHS 75.51, and DHS 75.52 Service Certification DQA English 08/2022 Word
F-03082E Initial Certification or Change of Ownership Application for DHS 75.53-DHS 75.58 Service Certification DQA English 09/2022 Word
F-03082B Initial Certification or Change of Ownership Application for DHS 75.59 Service Certification DQA English 08/2022 Word
F-03082D Initial Certification or Change of Ownership Application for DHS 75.60 Service Certification DQA English 08/2022 Word
F-47463J Initial EMS Service Providers Operational Plan Components Checklist DPH English 09/2022 Word
F-02996 Initial Lead Abatement Certification Application DPH English 03/2022 PDF
F-02031 Initial Lead Application - Individual Certification DPH English 03/2023 PDF
F-10097 Institutional Medicaid Income Allocation DMS English 06/2022 PDF
F-10097 Institutional Medicaid Income Allocation, Hmong DMS Hmong 06/2022 PDF
F-10097 Institutional Medicaid Income Allocation, Spanish DMS Spanish 06/2022 PDF
F-00286 Instructions DMS English 07/2015 PDF
F-01188 Instructions DMS English 02/2020 PDF
F-11040 Instructions DMS English 12/2019 PDF
F-00556 Instructions DMS English 01/2018 PDF
F-80112 Instructions DES English 06/2008 PDF
F-20942A Instructions OPIB English 05/2019 PDF
F-01187 Instructions DMS English 02/2018 PDF
F-00162 Instructions DMS English 05/2020 PDF
F-00950 Instructions DMS English 10/2022 PDF
F-11079 Instructions DMS English 07/2017 PDF
F-02382 Instructions DMS English 10/2020 PDF
F-00232 Instructions DMS English 12/2021 PDF
F-01189 Instructions DMS English 02/2020 PDF
F-11136 Instructions DMS English 10/2008 PDF
F-00202 Instructions (PDF, 177 KB) DCTS English 08/2016 PDF
F-80983 Instructions - Completing the Civil Rights Complaint OLC English 08/2018 PDF
F-80983 Instructions - Completing the Civil Rights Complaint, Hmong OLC Hmong 08/2018 PDF
F-80983 Instructions - Completing the Civil Rights Complaint, Spanish OLC Spanish 08/2018 PDF
F-00989i Instructions for Completing Wisconsin's Individualized Family Service Plan (IFSP) DMS English 03/2017 PDF
F-03112 Instructions for Logging HMO Appeals DMS English 12/2022 PDF
F-02466 Instructions for Logging MCO Appeals DMS English 12/2022 PDF
F-02466A Instructions for Logging MCO Grievances DMS English 12/2022 PDF
F-62022A Instructions for Report of Hours Worked and Resident Census Forms DQA English 02/2009 PDF
F-62022A Instructions for Report of Hours Worked and Resident Census Forms DQA English 02/2009 Word
F-00539 Instructions for the County Waiver Agency Support and Service Coordination (SSC) Rates DMS English 09/2019 PDF
F-44623 Instructions for WIC Time Study and Non-WIC Time Study DPH English 06/2020 PDF
F-20582 Instructions, English DMS English 03/2023 PDF
F-20582 Instructions, Hmong DMS Hmong 03/2023 PDF
F-00107 Instructions, Self-Employment Income Report DMS English 06/2019 PDF
F-00107 Instructions, Self-Employment Income Report, Chinese Mandarin DMS Chinese Mandarin 06/2019 PDF
F-00107 Instructions, Self-Employment Income Report, Hmong DMS Hmong 06/2019 PDF
F-00107 Instructions, Self-Employment Income Report, Spanish DMS Spanish 06/2019 PDF
Last revised April 13, 2023