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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-00237SE Appeal Request - MCOs - My Choice Wisconsin, Serbo-Croatian DMS Serbian (Serbo-Croatian) 02/2021 Word No
F-00237SO Appeal Request - MCOs - My Choice Wisconsin, Somali DMS Somali 02/2021 Word No
F-00237S Appeal Request - MCOs - My Choice Wisconsin, Spanish DMS Spanish 02/2021 Word No
F-80838 Applicant Consent for Criminal Background Check DES English 07/2021 Word No
F-43005 Applicant Physician Assurance for J-1 Visa Waiver Applications DPH English 10/2018 PDF No
F-45013 Application for a Radioactive Material License Authorizing the Use of Industrial Radiography DPH English 12/2011 PDF No
F-45013 Application for a Radioactive Material License Authorizing the Use of Industrial Radiography DPH English 12/2011 Word No
F-45012 Application for a Radioactive Material License for a Commercial Radiopharmacy DPH English 05/2010 Word No
F-45012 Application for a Radioactive Material License for a Commercial Radiopharmacy DPH English 05/2010 PDF No
F-45016 Application for a Radioactive Material License for Academic, Research and Development and Other Licenses of Limited Scope DPH English 05/2011 PDF No
F-45016 Application for a Radioactive Material License for Academic, Research and Development and Other Licenses of Limited Scope DPH English 05/2011 Word No
F-01588 Application for Available Beds DMS English 07/2015 Word No
F-02725 Application for COVID Connect Collection Site DPH English 10/2020 Word No
F-45022 Application for Material License DPH English 02/2005 PDF No
F-45022 Application for Material License DPH English 02/2005 Word No
F-45017 Application for Radioactive Material License Authorizing the Use of Sealed Sources DPH English 07/2003 PDF No
F-45017 Application for Radioactive Material License Authorizing the Use of Sealed Sources DPH English 07/2003 Word No
F-45009 Application for Radioactive Material License Authorizing the Use of Sealed Sources in Fixed Gauge Devices DPH English 05/2012 Word No
F-45009 Application for Radioactive Material License Authorizing the Use of Sealed Sources in Fixed Gauge Devices DPH English 05/2012 PDF No
F-45006 Application for Radioactive Material License Authorizing the Use of Sealed Sources in Portable Gages or XRF Devices DPH English 05/2010 PDF No
F-45006 Application for Radioactive Material License Authorizing the Use of Sealed Sources in Portable Gauges or XRF Devices DPH English 05/2010 Word No
F-45014 Application for Radioactive Material License Authorizing the Use of Self Shielded Irradiators DPH English 07/2008 Word No
F-45014 Application for Radioactive Material License Authorizing the Use of Self Shielded Irradiators DPH English 07/2008 PDF No
F-45015 Application for Radioactive Material License for Broad Scope DPH English 02/2005 Word No
F-45015 Application for Radioactive Material License for Broad Scope DPH English 02/2005 PDF No
F-45008 Application for Radioactive Material License for Medical Use DPH English 05/2010 PDF No
F-45008 Application for Radioactive Material License for Medical Use DPH English 05/2010 Word No
F-01827 Application for Reduction of Cost Share DMS English 12/2022 Word No
F-01827 Application for Reduction of Cost Share DMS English 12/2022 PDF No
F-01827LP Application for Reduction of Cost Share, Large Print DMS English 12/2022 PDF No
F-01827LP Application for Reduction of Cost Share, Large Print DMS English 12/2022 Word No
F-44011 Application for Registration of Lead-Free or Lead-Safe Property DPH English 03/2002 PDF No
F-47097 Application for Registration of X-Ray Devices DPH English 10/2018 PDF No
F-22468 Application for Services Office for the Blind and Visually Impaired DPH English 07/2016 Word No
F-22468 Application for Services Office for the Blind and Visually Impaired DPH English 07/2016 PDF No
F-02306 Application for Telecommunication Assistance Program (TAP) DPH English 06/2021 PDF No
F-02306 Application for Telecommunication Assistance Program (TAP) DPH English 07/2022 Word No
F-02306 Application for Telecommunication Assistance Program (TAP) DPH English 07/2022 HTML No
F-00926 Application for the Use of Protective Equipment or Mechanical Restraint - CLTS and CCOP DMS English 02/2022 PDF No
F-00926 Application for the Use of Protective Equipment or Mechanical Restraint - CLTS and CCOP DMS English 02/2022 Word No
F-02530 Application for Wisconsin's Test of English Proficiency (TEP) and Board for Examination of Interpreters (BEI) DPH English 08/2022 PDF No
F-02530 Application for Wisconsin's Test of English Proficiency (TEP) and Board for Examination of Interpreters (BEI) DPH English 08/2022 Word No
F-01268 Application to Conduct Intoxicated Driver Assessments, Tribal Treatment Facility DCTS English 09/2016 Word No
F-05009 Application to Purchase a Copy of a Certificate of Birth Resulting in a Stillbirth DPH English 05/2021 PDF No
F-22599 Appointment of Authorized Representative for Supplemental Security Income (SSI) DMS English 07/2008 PDF No
F-01804 Appointment Results Wisconsin WIC Program DPH English 02/2018 Word No
F-02052 Asbestos Abatement Project Log DPH English 03/2017 PDF No
F-44017 Asbestos Application - Individual DPH English 11/2022 PDF No
F-44017S Asbestos Application - Individual, Spanish DPH Spanish 11/2022 PDF No
F-44002 Asbestos Certification Application DPH English 05/2021 PDF No
Last revised July 18, 2023