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.
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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||Other Location||Language|
|F-05210||Name Change Request Within 1st Year||Other||English|
|F-05027A||Report of Citizenship||Other||English|
|F-05027B||Report of Naturalization||Other||English|
|F-05029||Request To Withdraw Voluntary Paternity Acknowledgement||Other||English|
|F-05032||Report of Birth Certificate Changes After Surrogate Birth||Other||English|
|F-05033||Birth Amendment - Baptismal||Other||English|
|F-05004||Birth Amendment - Affidavit||Other||English|
|F-05034||Birth Certificate Facts||Other||English|
|F-05035||Report Change Name, Sex Birth Certificate Surgical Procedure||None||English|
|F-05020||Paternity Order Due to Divorce - Judgement||Other||English|
|F-44118||WIC Vendor Application||Other||English|
|F-43021||Wisconsin Well Woman Program Multiple Sclerosis (MS) Report and Referral (PDF, 177 KB)||Other||English|
|F-62504||Community Substance Abuse Services (CSAS) or Mental Health Clinic Initial Certification Application||None||English|
|F-62674||Home Health Agency License Application||None||English|
|F-62461||Application for Critical Access Hospital Certification of Approval||Other||English|
|F-00119||Personal Care Agency Application for Approval||None||English|
|F-00140||Attestation and Acknowledgement for Provisional Approval as a Personal Care Agency||None||English|
|F-05218||E-mail Notification Request For New Publication Release||None||English|
|F-22540||Human Service Revenue Reporting - Expenditures by Revenue Source for Human Service Programs||None||English|
|F-21225||Program Participation System (PPS): B-3 Module||Other||English|
|F-10110||Medicaid/BadgerCare Plus Eligibility Certification||None||English|
|F-00343||Eligibility Management (Income Maintenance) Policy Notification Sign-Up||None||English|
|F-83271||DHS Website Feedback||None||English|
|F-24277||Informed Consent for Psychotropic Medication||None||English|
|F-44160A||WIC Plastic Cover for WIC ID Folder||Other||English|
|F-00917||Provider Enrollment Application Process||None||English|
|F-01361||ForwardHealth Provider Express Enrollment Change of Address||None||English|
|F-47181||First Responder Certification Card||None||English|
|F-47247||Ambulance Attendant License/Permit Renew||None||English|
|F-47471||Emergency Medical Technician Verification of Licensure||None||English|
|F-47255||Emergency Medical Services Funding Assistance Program Municipal Signature and Population Verification Page||None||English|
|F-47472||Emergency Medical Techician (EMT) License / First Responder Certification Renewal Application||None||English|
|F-47477||First Responder / Emergency Medical Technician Certificate / License||None||English|
|F-47478||First Responder / Emergency Medical Technician Application Electronic Addition to a Roster||None||English|