Forms Library

Forms produced by the Wisconsin Department of Health Services are available for downloading and printing from this site. If a form is not available electronically, you will be provided instructions for requesting a paper copy. If you are searching for a form number that does not start with the letter "F," just enter the number you have available and you will get a better search result. Example, looking for DDE-2539? Enter "2539" in the Search Forms field below.

The Division of Health Care Access and Accountability (DHCAA) and Division of Long Term Care (DLTC) have combined into the Division of Medicaid Services (DMS). When searching for forms by Division, please use the new acronym.

Assigned Number Title Division Other Location
F-42002 Warning: Do Not Unplug Refrigerator - Label DPH
F-05021 Report of Legal Name Change DPH
F-45025 Patient Questionnaire DPH
F-05035 Report Change Name, Sex Birth Certificate Surgical Procedure DPH
F-47204 Hazard Summary Form DPH
F-05027A Report of Citizenship DPH
F-42007 Mail Label 3 X 4 - Immunization Program DPH
F-44824 Wisconsin Day Care Assessment DPH
F-05098 Court Order to Correct Facts, Misrepresented Information DPH
F-05021C Report of Legal Name Change - Confidential DPH
F-45029 School Food Safety Program Inspection Report DPH
F-01320 Lead Test Kit Documentation DPH
F-05043 Notice of Removal - Corpse (Hospital, Nursing Home, Hospice) DPH
F-47219 Agent Change Sheet DPH
F-00017 Blood Lead Lab Reporting DPH
F-05027B Report of Naturalization DPH
F-12029 Managed Care Disenrollment Request DMS
F-05021T Report of Legal Name Change - Tribal DPH
F-45029i Instructions For School Food Safety Plan DPH
F-05044 Cause of Death Amendment DPH
F-47236 Operations and Maintenance Certificate DPH
F-00653a Patient Data Import Training DPH
F-47471 Emergency Medical Technician Verification of Licensure DPH
F-12085 BadgerCare Plus HMO Program HMO Enrollment Choice DMS
F-05022 Report of Adoption DPH


Last Revised: March 26, 2019