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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-03039 WCESIL Membership Agreement DPH English 05/2022 HTML No
F-01302 Weekly Driver's Vehicle Inspection Report DMS English 09/2019 PDF No
F-01302 Weekly Driver's Vehicle Inspection Report DMS English 09/2019 Word No
F-02007 WI HPP Exercise and Real Event Report DPH English 06/2022 HTML No
F-03025 WI Tribal Health Department: Diabetes Prevention Funding Progress Report DPH English 03/2023 HTML No
F-03076 WI Vaccine 3rd Party Scheduling Tracker DPH English 08/2022 HTML No
F-03075 WI Vaccine Support- All Calls Tracker DPH English 07/2022 HTML No
F-01821 WIC Authorized Infant Formula Supplier Application DPH English 04/2022 Word No
F-44624 WIC Budget - Current Year DPH English 06/2022 Excel No
F-44161A WIC Cardholder Rights and Responsibilities DPH English 08/2023 PDF No
F-44161AH WIC Cardholder Rights and Responsibilities, Hmong DPH Hmong 08/2023 PDF No
F-44161AS WIC Cardholder Rights and Responsibilities, Spanish DPH Spanish 08/2023 PDF No
F-00555T WIC CARS Expenditure Report Tribal Workbook DPH English 01/2022 Excel No
F-00555 WIC CARS Expenditure Report Workbook DPH English 01/2022 Excel No
F-00554 WIC Electronic Expenditure Report Certification DPH English 01/2012 Word No
F-44755 WIC Farmers' Market Nutrition Program DPH English 10/2000 HTML No
F-03043 WIC Medical Formula Order DPH English 06/2022 HTML No
F-02040 WIC Program Notice of Categorical Ineligibility DPH English 08/2023 Word No
F-02040H WIC Program Notice of Categorical Ineligibility, Hmong DPH Hmong 08/2023 Word No
F-02040S WIC Program Notice of Categorical Ineligibility, Spanish DPH Spanish 08/2023 Word No
F-40085 WIC Program Notice of Ineligibility DPH English 08/2023 PDF No
F-40085 WIC Program Notice of Ineligibility DPH English 08/2023 Word No
F-40085H WIC Program Notice of Ineligibility, Hmong DPH Hmong 08/2023 PDF No
F-40085S WIC Program Notice of Ineligibility, Spanish DPH Spanish 08/2023 PDF No
F-44024A WIC Request for Medical Food: Pregnant, Breastfeeding, and Nonbreastfeeding Postpartum Women DPH English 06/2023 Word No
F-44024D WIC Request for Medical Formula/Food: Infants and Children DPH English 06/2023 Word No
F-44161 WIC Rights and Responsibilities DPH English 07/2023 PDF No
F-44161 WIC Rights and Responsibilities DPH English 07/2023 HTML No
F-44161AL WIC Rights and Responsibilities, Albanian DPH Albanian 07/2023 PDF No
F-44161AL WIC Rights and Responsibilities, Albanian DPH Albanian 07/2023 HTML No
F-44161AR WIC Rights and Responsibilities, Arabic DPH Arabic 07/2023 HTML No
F-44161AR WIC Rights and Responsibilities, Arabic DPH Arabic 07/2023 PDF No
F-44161BU WIC Rights and Responsibilities, Burmese DPH Burmese 07/2023 PDF No
F-44161BU WIC Rights and Responsibilities, Burmese DPH Burmese 07/2023 HTML No
F-44161CC WIC Rights and Responsibilities, Chinese Cantonese DPH Chinese Cantonese 07/2023 HTML No
F-44161CC WIC Rights and Responsibilities, Chinese Cantonese DPH Chinese Cantonese 07/2023 PDF No
F-44161CM WIC Rights and Responsibilities, Chinese Mandarin DPH Chinese Mandarin 07/2023 HTML No
F-44161CM WIC Rights and Responsibilities, Chinese Mandarin DPH Chinese Mandarin 07/2023 PDF No
F-44161DA WIC Rights and Responsibilities, Dari DPH Dari 07/2023 PDF No
F-44161DA WIC Rights and Responsibilities, Dari DPH Dari 07/2023 HTML No
F-44161FR WIC Rights and Responsibilities, French DPH French 07/2023 HTML No
F-44161FR WIC Rights and Responsibilities, French DPH French 07/2023 PDF No
F-44161H WIC Rights and Responsibilities, Hmong DPH Hmong 07/2023 HTML No
F-44161H WIC Rights and Responsibilities, Hmong DPH Hmong 07/2023 PDF No
F-44161KA WIC Rights and Responsibilities, Karen DPH Karen 07/2023 HTML No
F-44161KA WIC Rights and Responsibilities, Karen DPH Karen 07/2023 PDF No
F-44161MA WIC Rights and Responsibilities, Malay DPH Malay 07/2023 HTML No
F-44161MA WIC Rights and Responsibilities, Malay DPH Malay 07/2023 PDF No
F-44161NE WIC Rights and Responsibilities, Nepali DPH Nepali 07/2023 PDF No
F-44161NE WIC Rights and Responsibilities, Nepali DPH Nepali 07/2023 HTML No
Last revised December 8, 2023