Forms Library

Forms produced by the Wisconsin Department of Health Services are available for downloading and printing from this site. If a form is not available electronically, you will be provided instructions for requesting a paper copy. If you are searching for a form number that does not start with the letter "F," just enter the number you have available and you will get a better search result. Example, looking for DDE-2539? Enter "2539" in the Search Forms field below.

The Division of Health Care Access and Accountability (DHCAA) and Division of Long Term Care (DLTC) have combined into the Division of Medicaid Services (DMS). When searching for forms by Division, please use the new acronym.

Assigned Number Title Other Locationsort descending
F-00119 Personal Care Agency Application for Approval
F-00140 Attestation and Acknowledgement for Provisional Approval as a Personal Care Agency
F-02069 DHS Quarterly Report on Consumers Enrolled in CCS
F-22540 Human Service Revenue Reporting - Expenditures by Revenue Source for Human Service Programs
F-21225 Program Participation System (PPS): B-3 Module
F-10110 Medicaid/BadgerCare Plus Eligibility Certification
F-83271 DHS Website Feedback
F-24277 Informed Consent for Psychotropic Medication
F-44160A WIC Plastic Cover for WIC ID Folder
F-00917 Provider Enrollment Application Process
F-01361 ForwardHealth Provider Express Enrollment Change of Address
F-00577 Report Fraud
F-01939 Wisconsin Medicaid Waiver Provider Registration
F-02008 CLTS Waivers Certification Exam
F-02331 Caregiver Programs Customer Satisfaction Survey
F-02341A Wisconsin Children's Long-Term Support (CLTS) Waiver Provider Registration
F-021343G AFCSP Fiscal Report
F-02124 2016 Comprehensive Community Services (CCS) Program Survey Worksheet
F-02341 County Waiver Agency Contact: Wisconsin Children's Long-Term Support (CLTS) Waiver Provider SharePoint Site
F-47181 First Responder Certification Card
F-47471 Emergency Medical Technician Verification of Licensure
F-47472 Emergency Medical Techician (EMT) License / First Responder Certification Renewal Application
F-47477 First Responder / Emergency Medical Technician Certificate / License
F-47478 First Responder / Emergency Medical Technician Application Electronic Addition to a Roster
F-47247 Ambulance Attendant License/Permit Renew
F-47255 Emergency Medical Services Funding Assistance Program Municipal Signature and Population Verification Page

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Last Revised: May 22, 2018