Official DHS 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 document, enter the number or a portion of the title in the search box below. To narrow your search results even more, place quotation marks (" ") around search terms.

If you are looking for an informative document, visit our Informative Documents and Publications Library. If you need a file in another file format or can't find what you are looking for here, reach out to the Digital Communications Team at dhsfmorder@dhs.wisconsin.gov. You can typically expect a response within 1-2 business days.

Assigned number Title Sort descending Division Language Release date File type Available to order
F-03395H Long-Term Care Program Enrollment and Referral, Hmong (DocuSign) DPH Hmong 12/2025 HTML
F-03395L Long-Term Care Program Enrollment and Referral, Laotian DPH Lao 12/2025 Word
F-03395L Long-Term Care Program Enrollment and Referral, Laotian (DocuSign) DPH Lao 12/2025 HTML
F-03395R Long-Term Care Program Enrollment and Referral, Russian DPH Russian 12/2025 Word
F-03395R Long-Term Care Program Enrollment and Referral, Russian (DocuSign) DPH Russian 12/2025 HTML
F-03395SO Long-Term Care Program Enrollment and Referral, Somali DPH Somali 12/2025 Word
F-03395SO Long-Term Care Program Enrollment and Referral, Somali (DocuSign) DPH Somali 12/2025 HTML
F-03395S Long-Term Care Program Enrollment and Referral, Spanish DPH Spanish 12/2025 Word
F-03395SO Long-Term Care Program Enrollment and Referral, Spanish (DocuSign) DPH Spanish 12/2025 HTML
F-03395UK Long-Term Care Program Enrollment and Referral, Ukrainian DPH Ukrainian 12/2025 Word
F-03395UK Long-Term Care Program Enrollment and Referral, Ukrainian (DocuSign) DPH Ukrainian 12/2025 HTML
F-03395V Long-Term Care Program Enrollment and Referral, Vietnamese DPH Vietnamese 12/2025 Word
F-03395V Long-Term Care Program Enrollment and Referral, Vietnamese (DocuSign) DPH Vietnamese 12/2025 HTML
F-03397 Long-Term Care Program Member or Participant Request to Transfer and Enroll DPH English 12/2025 Word
F-03397 Long-Term Care Program Member or Participant Request to Transfer and Enroll (DocuSign) DPH English 12/2025 HTML
F-03397AR Long-Term Care Program Member or Participant Request to Transfer and Enroll, Arabic DPH Arabic 12/2025 Word
F-03397AR Long-Term Care Program Member or Participant Request to Transfer and Enroll, Arabic (DocuSign) DPH Arabic 12/2025 HTML
F-03397BU Long-Term Care Program Member or Participant Request to Transfer and Enroll, Burmese DPH Burmese 12/2025 Word
F-03397BU Long-Term Care Program Member or Participant Request to Transfer and Enroll, Burmese (DocuSign) DPH Burmese 12/2025 HTML
F-03397CM Long-Term Care Program Member or Participant Request to Transfer and Enroll, Chinese (Simplified) DPH Chinese (Simplified) 12/2025 Word
F-03397CM Long-Term Care Program Member or Participant Request to Transfer and Enroll, Chinese (Simplified) (DocuSign) DPH Chinese (Simplified) 12/2025 HTML
F-03397H Long-Term Care Program Member or Participant Request to Transfer and Enroll, Hmong DPH Hmong 12/2025 Word
F-03397H Long-Term Care Program Member or Participant Request to Transfer and Enroll, Hmong (DocuSign) DPH Hmong 12/2025 HTML
F-03397L Long-Term Care Program Member or Participant Request to Transfer and Enroll, Laotian DPH Lao 12/2025 Word
F-03397L Long-Term Care Program Member or Participant Request to Transfer and Enroll, Laotian (DocuSign) DPH Lao 12/2025 HTML
F-03397R Long-Term Care Program Member or Participant Request to Transfer and Enroll, Russian DPH Russian 12/2025 Word
F-03397R Long-Term Care Program Member or Participant Request to Transfer and Enroll, Russian (DocuSign) DPH Russian 12/2025 HTML
F-03397SO Long-Term Care Program Member or Participant Request to Transfer and Enroll, Somali DPH Somali 12/2025 Word
F-03397SO Long-Term Care Program Member or Participant Request to Transfer and Enroll, Somali (DocuSign) DPH Somali 12/2025 HTML
F-03397S Long-Term Care Program Member or Participant Request to Transfer and Enroll, Spanish DPH Spanish 12/2025 Word
F-03397S Long-Term Care Program Member or Participant Request to Transfer and Enroll, Spanish (DocuSign) DPH Spanish 12/2025 HTML
F-03397UK Long-Term Care Program Member or Participant Request to Transfer and Enroll, Ukrainian DPH Ukrainian 12/2025 Word
F-03397UK Long-Term Care Program Member or Participant Request to Transfer and Enroll, Ukrainian (DocuSign) DPH Ukrainian 12/2025 HTML
F-03397V Long-Term Care Program Member or Participant Request to Transfer and Enroll, Vietnamese DPH Vietnamese 12/2025 Word
F-03397V Long-Term Care Program Member or Participant Request to Transfer and Enroll, Vietnamese (DocuSign) DPH Vietnamese 12/2025 HTML
F-03396 Long-Term Care Program Member or Participant Requested Disenrollment DPH English 12/2025 Word
F-03396 Long-Term Care Program Member or Participant Requested Disenrollment (DocuSign) DPH English 12/2025 HTML
F-03396AR Long-Term Care Program Member or Participant Requested Disenrollment, Arabic DPH Arabic 12/2025 Word
F-03396AR Long-Term Care Program Member or Participant Requested Disenrollment, Arabic (DocuSign) DPH Arabic 12/2025 HTML
F-03396BU Long-Term Care Program Member or Participant Requested Disenrollment, Burmese DPH Burmese 12/2025 Word
F-03396BU Long-Term Care Program Member or Participant Requested Disenrollment, Burmese (DocuSign) DPH Burmese 12/2025 HTML
F-03396CM Long-Term Care Program Member or Participant Requested Disenrollment, Chinese (Simplified) DPH Chinese (Simplified) 12/2025 Word
F-03396CM Long-Term Care Program Member or Participant Requested Disenrollment, Chinese (Simplified) (DocuSign) DPH Chinese (Simplified) 12/2025 HTML
F-03396H Long-Term Care Program Member or Participant Requested Disenrollment, Hmong DPH Hmong 12/2025 Word
F-03396H Long-Term Care Program Member or Participant Requested Disenrollment, Hmong (DocuSign) DPH Hmong 12/2025 HTML
F-03396L Long-Term Care Program Member or Participant Requested Disenrollment, Laotian DPH Lao 12/2025 Word
F-03396L Long-Term Care Program Member or Participant Requested Disenrollment, Laotian (DocuSign) DPH Lao 12/2025 HTML
F-03396R Long-Term Care Program Member or Participant Requested Disenrollment, Russian DPH Russian 12/2025 Word
F-03396R Long-Term Care Program Member or Participant Requested Disenrollment, Russian (DocuSign) DPH Russian 12/2025 HTML
F-03396SO Long-Term Care Program Member or Participant Requested Disenrollment, Somali DPH Somali 12/2025 Word

Glossary

 
Last revised October 27, 2025