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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-20818S Certification for SSI-E Exceptional Expense Supplement, Spanish DMS Spanish 08/2008 PDF No
F-01162 Certification of Emergency for Non-U.S. Citizens DMS English 02/2009 PDF No
F-01162A Certification of Emergency for Non-U.S. Citizens Completion Instructions DMS English 02/2009 PDF No
F-11047 Certification of Need for Elective / Urgent Psychiatric / Substance Abuse Admissions to Hospital Institutions for Mental Disease for Members Under Age 21 DMS English 02/2009 PDF No
F-01197 Certification of Need for Specialized Medical Vehicle Transportation DMS English 06/2009 PDF No
F-01197 Certification of Need for Specialized Medical Vehicle Transportation DMS English 06/2009 Word No
F-01197A Certification of Need for Specialized Medical Vehicle Transportation Completion Instructions DMS English 06/2009 PDF No
F-01788 Certification Regarding Debarment and Suspension DES English 03/2022 Word No
F-62586 Challenge Exam Applicant Nurse Aide / Medication Aide DQA English 08/2022 PDF No
F-62586 Challenge Exam Applicant Nurse Aide / Medication Aide DQA English 08/2022 Word No
F-47470 Change of EMS Medical Director DPH English 02/2022 PDF No
F-47470 Change of EMS Medical Director DPH English 02/2022 Word No
F-00615 Change Project Report and Instructions DPH English 12/2018 Word No
F-00615A Change Project Summary and Instructions DPH English 05/2018 Word No
F-00989A Child and Family Information (IFSP) DMS English 02/2017 Word No
F-00989AS Child and Family Information (IFSP), Spanish DMS Spanish 02/2017 Word No
F-44215 Child Care Center Report to the District Attorney DPH English 12/2017 PDF No
F-03391 Child Care Coordination (CCC) Care Plan DMS English 07/2025 PDF No
F-03391 Child Care Coordination (CCC) Care Plan DMS English 07/2025 Word No
F-03391A Child Care Coordination (CCC) Care Plan Instructions DMS English 07/2025 PDF No
F-01118 Child Care Coordination (CCC) Family Questionnaire Domains and Questions DMS English 07/2025 Word No
F-01118 Child Care Coordination (CCC) Family Questionnaire Domains and Questions DMS English 07/2025 PDF No
F-01118H Child Care Coordination (CCC) Family Questionnaire Domains and Questions, Hmong DMS Hmong 07/2025 Word No
F-01118H Child Care Coordination (CCC) Family Questionnaire Domains and Questions, Hmong DMS Hmong 07/2025 PDF No
F-01118S Child Care Coordination (CCC) Family Questionnaire Domains and Questions, Spanish DMS Spanish 07/2025 Word No
F-01118S Child Care Coordination (CCC) Family Questionnaire Domains and Questions, Spanish DMS Spanish 07/2025 PDF No
F-03390 Child Care Coordination Care Coordinator Visit Checklist DMS English 07/2025 PDF No
F-03390 Child Care Coordination Care Coordinator Visit Checklist DMS English 07/2025 Word No
F-03257 Child Care Coordination Monthly Time Log for Ongoing Care Coordination and Monitoring DMS English 12/2023 Word No
F-03257 Child Care Coordination Monthly Time Log for Ongoing Care Coordination and Monitoring DMS English 12/2023 PDF No
F-03257A Child Care Coordination Monthly Time Log for Ongoing Care Coordination and Monitoring, Instructions DMS English 12/2023 PDF No
F-03362 Child Care Coordination Personnel and Training Plan DMS English 02/2025 Word No
F-03362 Child Care Coordination Personnel and Training Plan DMS English 02/2025 PDF No
F-03361 Child Care Coordination Plan of Operation DMS English 02/2025 Word No
F-03361 Child Care Coordination Plan of Operation DMS English 02/2025 PDF No
F-03256 Child Care Coordination Referral DMS English 07/2025 PDF No
F-03256 Child Care Coordination Referral DMS English 07/2025 Word No
F-44019A Child Care Immunization Assessment DPH English 03/2025 PDF No
F-44019AS Child Care Immunization Assessment, Spanish DPH Spanish 03/2025 PDF No
F-44192 Child Care Immunization Record DPH English 03/2025 PDF No
F-44192S Child Care Immunization Record, Spanish DPH Spanish 03/2025 PDF No
F-00316 Child Enrollment Status Regarding Birth to 3 Program DMS English 03/2017 Word No
F-00316S Child Enrollment Status Regarding Birth to 3 Program, Spanish DMS Spanish 03/2017 Word No
F-00479 Child Outcomes Fidelity Self-Assessment DMS English 02/2017 Word No
F-00480 Child Outcomes Summary DMS English 02/2017 Word No
F-00989H Child/Family Outcome (IFSP) DMS English 02/2017 Word No
F-00989HS Child/Family Outcome (IFSP), Spanish DMS Spanish 02/2017 Word No
F-01997 Children's Community Options (CCOP) Reconciliation Packet DMS English 02/2022 Excel No
F-01997I Children's Community Options (CCOP) Reconciliation Packet, Instructions DMS English 02/2022 PDF No
F-02587 Children's Long-Term Support (CLTS) Waiver Program Deciding Together Implementation Planning Tool DMS English 12/2019 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.

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Last revised October 27, 2025