Skip to main content

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-44161R WIC Rights and Responsibilities, Russian DPH Russian 07/2023 PDF No
F-44161SO WIC Rights and Responsibilities, Somali DPH Somali 07/2023 PDF No
F-44161SO WIC Rights and Responsibilities, Somali DPH Somali 07/2023 HTML No
F-44161S WIC Rights and Responsibilities, Spanish DPH Spanish 07/2023 PDF No
F-44161S WIC Rights and Responsibilities, Spanish DPH Spanish 07/2023 HTML No
F-44161SW WIC Rights and Responsibilities, Swahili DPH Swahili 07/2023 HTML No
F-44161SW WIC Rights and Responsibilities, Swahili DPH Swahili 07/2023 PDF No
F-44621 WIC Stock Price Survey DPH English 04/2023 PDF No
F-44323 WIC Stock Price Survey: Pharmacy Only DPH English 11/2021 PDF No
F-44324 WIC Vendor Pre-Authorization Site Visit Report DPH English 10/2021 PDF No
F-44727 WIC Vendor Proof of Training (online submission) DPH English 09/2021 HTML No
F-44727A WIC Vendor Proof of Training (printable) DPH English 11/2021 PDF No
F-44444 WIC Vendor Supply Order DPH English 10/2023 Word No
F-02923 WIIN Grant Child Care Provider Questionnaire DPH English 12/2021 HTML No
F-03046 WIR Help Desk - Customer Satisfaction Survey DPH English 06/2022 HTML No
F-02288 WisCaregiver Career Program: Registration Agreement DQA English 05/2019 Word No
F-01185 Wisconsin Adult Cystic Fibrosis Program Application DMS English 08/2020 PDF No
F-01185AH Wisconsin Adult Cystic Fibrosis Program Application Instructions, Hmong DMS Hmong 08/2020 PDF No
F-01185AS Wisconsin Adult Cystic Fibrosis Program Application Instructions, Spanish DMS Spanish 08/2020 PDF No
F-01185H Wisconsin Adult Cystic Fibrosis Program Application, Hmong DMS Hmong 08/2020 PDF No
F-01185A Wisconsin Adult Cystic Fibrosis Program Application, Instructions DMS English 08/2020 PDF No
F-01185S Wisconsin Adult Cystic Fibrosis Program Application, Spanish DMS Spanish 08/2020 PDF No
F-01188 Wisconsin Adult Cystic Fibrosis Program Financial Need Statement DMS English 02/2018 PDF No
F-01188A Wisconsin Adult Cystic Fibrosis Program Financial Need Statement Instructions DMS English 07/2024 PDF No
F-01188AH Wisconsin Adult Cystic Fibrosis Program Financial Need Statement Instructions, Hmong DMS Hmong 07/2024 PDF No
F-01188AS Wisconsin Adult Cystic Fibrosis Program Financial Need Statement Instructions, Spanish DMS Spanish 07/2024 PDF No
F-01188H Wisconsin Adult Cystic Fibrosis Program Financial Need Statement, Hmong DMS Hmong 02/2018 PDF No
F-01188S Wisconsin Adult Cystic Fibrosis Program Financial Need Statement, Spanish DMS Spanish 02/2018 PDF No
F-01144 Wisconsin Adult Cystic Fibrosis Program Residency and Health Care Benefits Verification DMS English 02/2018 PDF No
F-01144H Wisconsin Adult Cystic Fibrosis Program Residency and Health Care Benefits Verification, Hmong DMS Hmong 02/2018 PDF No
F-01144S Wisconsin Adult Cystic Fibrosis Program Residency and Health Care Benefits Verification, Spanish DMS Spanish 02/2018 PDF No
F-00366 Wisconsin Adult Long-Term Care Functional Screen DMS English 10/2024 Word No
F-02425 Wisconsin Alzheimer’s Family Caregiver Support Program (AFCSP) Home-Delivered Meals Contribution Authorization DPH English 06/2023 Word No
F-20441AI Wisconsin APS Incident Data Collection Data Dictionary DPH English 12/2024 PDF No
F-20441A Wisconsin APS Incident Data Collection Form DPH English 12/2024 Word No
F-01336 Wisconsin Assessment of the Impaired Driver (WAID) and Other Substance Users DCTS English 10/2016 Paper Only Yes
F-02574 Wisconsin Assistive Technology Advisory Council Application DPH English 11/2019 PDF No
F-03168 Wisconsin Asthma-Safe Homes Program Asthma Education Training Provider Grant Application DPH English 06/2024 Word No
F-03169 Wisconsin Asthma-Safe Homes Program Asthma Environmental Services Training Provider Grant Application DPH English 06/2024 Word No
F-03031 Wisconsin Asthma-Safe Homes Program Education Services Provider Grant Application DPH English 06/2024 Word No
F-03032 Wisconsin Asthma-Safe Homes Program Environmental Services Provider Grant Application DPH English 06/2024 Word No
F-05291 Wisconsin Birth Certificate Application DPH English 12/2023 PDF No
F-05291S Wisconsin Birth Certificate Application, Spanish DPH Spanish 01/2024 PDF No
F-02541S Wisconsin Birth Defects Condition Nomination DPH Spanish 11/2019 Word No
F-02541 Wisconsin Birth Defects Condition Nomination DPH English 11/2019 PDF No
F-02541 Wisconsin Birth Defects Condition Nomination DPH English 11/2019 Word No
F-02541S Wisconsin Birth Defects Condition Nomination, Spanish DPH Spanish 11/2019 PDF No
F-40056 Wisconsin Birth Defects Registry (WBDR) User Security and Confidentiality Agreement DPH English 06/2023 PDF No
F-00915 Wisconsin Birth to 3 Program - Data Discussion Evaluation DMS English 02/2017 Word No
F-00915A Wisconsin Birth to 3 Program - Request for Data Discussion Certificate of Attendance DMS English 02/2017 Word 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