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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 Division Language Release Date File Type Available to Order
F-00381 Outpatient Mental Health Clinic Certification Withdrawal Checklist DQA English 03/2011 Word No
F-00381 Outpatient Mental Health Clinic Certification Withdrawal Checklist DQA English 03/2011 PDF No
F-00785 Outpatient Mental Health Clinic Recertification Application - DHS 35 DQA English 08/2016 PDF No
F-00785 Outpatient Mental Health Clinic Recertification Application - DHS 35 DQA English 08/2016 Word No
F-00059 Outpatient Mental Health Clinics Initial Certification Application - DHS 35 DQA English 06/2024 Word No
F-02610 Owner-Occupied Properties - Lead-Safe Homes Program Application DPH English 03/2024 PDF No
F-02610S Owner-Occupied Properties - Lead-Safe Homes Program Application, Spanish DPH Spanish 03/2024 PDF No
F-02483 PACE Program Enrollment DPH English 02/2024 Word No
F-02483 PACE Program Enrollment (DocuSign) DPH English 02/2024 HTML No
F-02483LP PACE Program Enrollment (Large Print) DPH English 02/2024 Word No
F-02483AR PACE Program Enrollment, Arabic DPH Arabic 02/2024 PDF No
F-02483CM PACE Program Enrollment, Chinese (Simplified) DPH Chinese (Simplified) 02/2024 Word No
F-02483H PACE Program Enrollment, Hmong DPH Hmong 02/2024 Word No
F-02483L PACE Program Enrollment, Laotian DPH Laotian 02/2024 Word No
F-02483R PACE Program Enrollment, Russian DPH Russian 02/2024 Word No
F-02483SE PACE Program Enrollment, Serbo-Croatian DPH Serbian (Serbo-Croatian) 02/2024 Word No
F-02483SO PACE Program Enrollment, Somali DPH Somali 02/2024 Word No
F-02483S PACE Program Enrollment, Spanish DPH Spanish 02/2024 Word No
F-02484 Pace Program Member Requested Disenrollment or Transfer Instructions DPH English 02/2024 Word No
F-02484 Pace Program Member Requested Disenrollment or Transfer Instructions (DocuSign) DPH English 02/2024 HTML No
F-02484LP Pace Program Member Requested Disenrollment or Transfer Instructions (Large Print) DPH English 02/2024 Word No
F-02484AR Pace Program Member Requested Disenrollment or Transfer Instructions, Arabic DPH Arabic 02/2024 PDF No
F-02484CM Pace Program Member Requested Disenrollment or Transfer Instructions, Chinese (Simplified) DPH Chinese (Simplified) 02/2024 Word No
F-02484H Pace Program Member Requested Disenrollment or Transfer Instructions, Hmong DPH Hmong 02/2024 Word No
F-02484L Pace Program Member Requested Disenrollment or Transfer Instructions, Laotian DPH Laotian 02/2024 Word No
F-02484R Pace Program Member Requested Disenrollment or Transfer Instructions, Russian DPH Russian 02/2024 Word No
F-02484SE Pace Program Member Requested Disenrollment or Transfer Instructions, Serbo-Croatian DPH Serbian (Serbo-Croatian) 02/2024 Word No
F-02484SO Pace Program Member Requested Disenrollment or Transfer Instructions, Somali DPH Somali 02/2024 Word No
F-02484S Pace Program Member Requested Disenrollment or Transfer Instructions, Spanish DPH Spanish 02/2024 Word No
F-02331 Paper Version Caregiver Programs Customer Satisfaction Survey DPH English 05/2018 Word No
F-02331S Paper Version Caregiver Programs Customer Satisfaction Survey, Spanish DPH Spanish 05/2018 Word No
F-47463E Paramedic Operational Plan Components DPH English 06/2012 PDF No
F-40044 Participant Agreement, Rights & Responsibilities DPH English 03/2023 PDF Yes
F-40044S Participant Agreement, Rights & Responsibilities, Spanish DPH Spanish 03/2023 PDF No
F-40028 Participant Determination Letter DPH English 05/2023 PDF No
F-40028R Participant Determination Letter, Russian DPH Russian 05/2023 PDF No
F-40028S Participant Determination Letter, Spanish DPH Spanish 05/2023 PDF No
F-01293D Participant Fiscal Employer Agent (FEA) Change Request DMS English 04/2023 Word No
F-02764 Participant Fiscal Employer Agent (FEA) – Transfer Request (DocuSign) DPH English 10/2024 HTML No
F-02957 Participant Integrity Investigation Wisconsin Women, Infants, and Children (WIC) Program DPH English 02/2022 Word No
F-20985 Participant Rights and Responsibilities Notification DMS English 04/2025 PDF No
F-20985H Participant Rights and Responsibilities Notification, Hmong DMS Hmong 04/2025 PDF No
F-20985KA Participant Rights and Responsibilities Notification, Karen DMS Karen 04/2025 PDF No
F-20985RY Participant Rights and Responsibilities Notification, Rohingya DMS Rohingya 04/2025 PDF No
F-20985SO Participant Rights and Responsibilities Notification, Somali DMS Somali 04/2025 PDF No
F-20985S Participant Rights and Responsibilities Notification, Spanish DMS Spanish 04/2025 PDF No
F-20985V Participant Rights and Responsibilities Notification, Vietnamese DMS Vietnamese 04/2025 PDF No
F-01689 Participant-Hired Worker 40-Hour Health And Safety Assurance Exception Request - IRIS Program DMS English 03/2018 Word No
F-03078 Participation Agreement - Environmental Services DPH English 10/2024 PDF No
F-03078S Participation Agreement - Environmental Services, Spanish DPH Spanish 10/2024 PDF No

DHS is required under Wis. Stat. § 15.04(1) to establish and maintain a forms management program, appoint a forms officer, and establish and maintain a numbering and filing system for official forms.

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Last revised December 4, 2024