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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-62308 Authorization to Accept Personal Service and Receive Registered and Certified Mail DQA English 06/2013 Word No
F-02716 Authorization to Allocate Elder Benefit Specialist Funding to the Aging and Disability Resource Center (ADRC) DPH English 06/2024 PDF No
F-14014 Authorization to Disclose Information to Disability Determination Bureau (DDB) DMS English 03/2022 PDF No
F-14014H Authorization to Disclose Information to Disability Determination Bureau (DDB), Hmong DMS Hmong 03/2022 PDF No
F-14014S Authorization to Disclose Information to Disability Determination Bureau (DDB), Spanish DMS Spanish 03/2022 PDF No
F-01829 Authorization to Receive and Disclose Information - HIV Drug Assistance and Insurance Assistance Programs DPH English 01/2025 Word No
F-00048 Authorization To Receive Tetanus, diphtheria, acellular pertussis (Tdap), Meningococcal Conjugate (MCV4) and/or Human Papilloma Virus (HPV) Vaccine(s) DPH English 08/2016 PDF No
F-00048S Authorization To Receive Tetanus, diphtheria, acellular pertussis (Tdap), Meningococcal Conjugate (MCV4) and/or Human Papilloma Virus (HPV) Vaccine(s), Spanish DPH Spanish 08/2016 PDF No
F-00101 Authorization to Request Birth Records DMS English 06/2019 Word No
F-02906 Authorization to Transfer Aging and Disability Services GPR Funding to Another Agency DPH English 08/2024 Word No
F-20987 Authorized Representative Designation Medicaid Community Waiver Programs DMS English 03/2017 PDF No
F-20987 Authorized Representative Designation Medicaid Community Waiver Programs DMS English 03/2017 Word No
F-20987S Authorized Representative Designation Medicaid Community Waiver Programs, Spanish DMS Spanish 03/2017 Word No
F-02118 Authorized Signer Designation for Access to PPS and FSIA DMS English 09/2022 PDF No
F-01352 Background Check Appeal Request - IRIS Program DMS English 02/2019 Word No
F-01352H Background Check Appeal Request - IRIS Program, Hmong DMS Hmong 02/2019 Word No
F-01352R Background Check Appeal Request - IRIS Program, Russian DMS Russian 02/2019 Word No
F-01352S Background Check Appeal Request - IRIS Program, Spanish DMS Spanish 02/2019 Word No
F-82064 Background Information Disclosure (BID) DQA English 01/2022 PDF No
F-82069 Background Information Disclosure (BID) Appendix for License Holders and Non Client Residents in DQA-Regulated Facilities DQA English 06/2018 Word No
F-82069A Background Information Disclosure (BID) Appendix Instructions DQA English 06/2018 PDF No
F-82064A Background Information Disclosure (BID) Instructions DQA English 01/2022 PDF No
F-82064AH Background Information Disclosure (BID) Instructions, Hmong DQA Hmong 01/2022 PDF No
F-82064AS Background Information Disclosure (BID) Instructions, Spanish DQA Spanish 01/2022 PDF No
F-82064H Background Information Disclosure (BID), Hmong DQA Hmong 01/2022 PDF No
F-82064S Background Information Disclosure (BID), Spanish DQA Spanish 01/2022 PDF No
F-03155 Background Information Disclosure Addendum - ILSP DPH English 07/2023 PDF No
F-03155H Background Information Disclosure Addendum - ILSP, Hmong DPH Hmong 07/2023 PDF No
F-03155LP Background Information Disclosure Addendum - ILSP, Large Print DPH English 07/2023 PDF No
F-03155SO Background Information Disclosure Addendum - ILSP, Somali DPH Somali 07/2023 PDF No
F-03155S Background Information Disclosure Addendum - ILSP, Spanish DPH Spanish 07/2023 PDF No
F-01246 Background Information Disclosure Addendum: IRIS DMS English 01/2024 Word No
F-01246H Background Information Disclosure Addendum: IRIS, Hmong DMS Hmong 01/2024 Word No
F-01246R Background Information Disclosure Addendum: IRIS, Russian DMS Russian 01/2024 Word No
F-01246S Background Information Disclosure Addendum: IRIS, Spanish DMS Spanish 01/2024 Word No
F-10081 BadgerCare Plus - Express Enrollment for Pregnant Women Application DMS English 02/2014 PDF Yes
F-10081A BadgerCare Plus - Express Enrollment for Pregnant Women Application Instructions DMS English 02/2025 PDF No
F-10115 BadgerCare Plus / Medicaid Health Insurance Information DMS English 01/2011 PDF No
F-10115S BadgerCare Plus / Medicaid Health Insurance Information, Spanish DMS Spanish 01/2011 PDF No
F-10182 BadgerCare Plus Application Packet DMS English 07/2024 PDF Yes
F-10182DA BadgerCare Plus Application Packet, Dari DMS Dari (Afghan Persian) 07/2024 PDF No
F-10182H BadgerCare Plus Application Packet, Hmong DMS Hmong 07/2024 PDF No
F-10182PA BadgerCare Plus Application Packet, Pashto DMS Pashto 07/2024 PDF No
F-10182S BadgerCare Plus Application Packet, Spanish DMS Spanish 07/2024 PDF No
F-10185 BadgerCare Plus Child Welfare Parent / Caretaker Relative (CWPC) Communication DMS English 09/2019 Word No
F-11309 BadgerCare Plus Express Enrollment for Children Provider Certification OIG English 01/2021 PDF No
F-11268 BadgerCare Plus Express Enrollment for Pregnant Women Provider Certification OIG English 01/2021 PDF No
F-10184 BadgerCare Plus Former Foster Care Youth (FFCY) DMS English 09/2019 Word No
F-13025 BadgerCare Plus Premium Employer Wage Withholding and Instructions DMS English 09/2013 PDF No
F-10139 BadgerCare Plus Premium Information / Payment DMS English 03/2018 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