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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-00989C Summary of Development Child’s Positive Social Emotional Skills (IFSP) DMS English 02/2017 Word No
F-00989CS Summary of Development Child’s Positive Social Emotional Skills (IFSP), Spanish DMS Spanish 02/2017 Word No
F-00989D Summary of Development Child’s Use of Knowledge and Skills (IFSP) DMS English 02/2017 Word No
F-00989DS Summary of Development Child’s Use of Knowledge and Skills (IFSP), Spanish DMS Spanish 02/2017 Word No
F-00098 Summary of Information Letter DMS English 06/2019 PDF No
F-00989L Summary of Services (IFSP) DMS English 02/2017 Word No
F-00989LS Summary of Services (IFSP), Spanish DMS Spanish 02/2017 Word No
F-02620 Supervised Release (SR) Client Contact Request DCTS English 02/2020 Word No
F-02616 Supervised Release (SR) Client Vehicle Purchase Request DCTS English 02/2020 Word No
F-02616S Supervised Release (SR) Client Vehicle Purchase Request, Spanish DCTS Spanish 02/2020 Word No
F-02661 Supervised Release Client Work/Education Request DCTS English 05/2020 Word No
F-02522 Supervised Release Individual Client Summary DCTS English 10/2021 Word No
F-25615 Supervised Release Rules DCTS English 03/2025 Word No
F-25615S Supervised Release Rules, Spanish DCTS Spanish 03/2025 Word No
F-01305 Supplemental Security Income-Related Determination DMS English 03/2017 PDF No
F-02435 Support and Service Coordinator Waiver Basics Training Requirement Attestation DMS English 12/2018 Word No
F-02377 Supported Decision-Making Agreement DPH English 08/2018 Word No
F-02377 Supported Decision-Making Agreement DPH English 08/2018 PDF No
F-02377AR Supported Decision-Making Agreement, Arabic DPH Arabic 08/2018 PDF No
F-02377S Supported Decision-Making Agreement, Spanish DPH Spanish 08/2018 PDF No
F-02377S Supported Decision-Making Agreement, Spanish DPH Spanish 08/2018 Word No
F-02384 Syndromic Surveillance Data Use Application DPH English 12/2023 PDF No
F-47463F Tactical EMS Service Provider Operational Plan Components Checklist DPH English 09/2022 Word No
F-40063 TEFAP / CSFP Commodities Complaint DPH English 04/2023 Word No
F-40062 TEFAP / CSFP Commodity Loss Report DPH English 07/2004 Word No
F-00989G Tell Us About Your Family (IFSP) DMS English 02/2017 Word No
F-00989GS Tell Us About Your Family (IFSP), Spanish DMS Spanish 02/2017 Word No
F-02257 Temperature Excursion Incident Report - Wisconsin Immunization Program DPH English 02/2024 Word No
F-02619 Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials DMS English 02/2021 Word No
F-02619AR Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials, Arabic DMS Arabic 02/2021 Word No
F-02619CM Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials, Chinese (Simplified) DMS Chinese (Simplified) 02/2021 Word No
F-02619H Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials, Hmong DMS Hmong 02/2021 Word No
F-02619L Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials, Laotian DMS Laotian 02/2021 Word No
F-02619SE Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials, Serbo-Croatian DMS Serbian (Serbo-Croatian) 02/2021 Word No
F-02619SO Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials, Somali DMS Somali 02/2021 Word No
F-02619S Template Language Managed Care Organizations are Required to Use in Grievance and Appeal Materials, Spanish DMS Spanish 02/2021 Word No
F-10119 Temporary Enrollment for Family Planning Only Services DMS English 02/2024 PDF Yes
F-10119A Temporary Enrollment for Family Planning Only Services Application Instructions DMS English 02/2025 PDF No
F-02260 Temporary QUEST Card Issuance Worker Checklist DMS English 12/2023 PDF No
F-02260A Temporary QUEST Card Request DMS English 10/2023 PDF No
F-02260ABU Temporary QUEST Card Request, Burmese DMS Burmese 10/2023 PDF No
F-02260ACM Temporary QUEST Card Request, Chinese (Simplified) DMS Chinese (Simplified) 10/2023 PDF No
F-02260AG Temporary QUEST Card Request, German DMS German 10/2023 PDF No
F-02260AH Temporary QUEST Card Request, Hmong DMS Hmong 10/2023 PDF No
F-02260AR Temporary QUEST Card Request, Russian DMS Russian 10/2023 PDF No
F-02260ASO Temporary QUEST Card Request, Somali DMS Somali 10/2023 PDF No
F-02260AS Temporary QUEST Card Request, Spanish DMS Spanish 10/2023 PDF No
F-01330A Temporary Shelter (Community Partner/Non-LTC) DPH English 12/2014 Word No
F-01330 Temporary Shelter (Like Facility) DPH English 08/2014 Word No
F-02436 Testing Questionnaire (AIDS/HIV) DPH English 02/2020 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.

Glossary

 
Last revised December 4, 2024