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 Numbersort ascending Title Other Location Language
F-47463B Emergency Medical Techician (EMT) - Basic Operational Plan Components (PDF, 26 KB) English
F-47463A First Responder Operational Plan Components (PDF, 19 KB) English
F-47463 Emergency Medical Service (EMS) Provider Application and Operational Plan English
F-47461D Label-Prewash English
F-47461C Label-Sanatize English
F-47461B Label-Rinse English
F-47461A Label-Wash English
F-47454 Tattoo and Body Piercing Inspection Report (PDF, 2.9 MB) English
F-47300 Ambulance Run Report (page 3) Skills /  Extended Comments (PDF, 55 KB) English
F-47257 Program Expenditure Report - Emergency Medical Service Funding Assistance For Ambulance Service Providers English
F-47255 Emergency Medical Services Funding Assistance Program Municipal Signature and Population Verification Page English
F-47247 Ambulance Attendant License/Permit Renew English
F-47242 Asbestos Certification Application English
F-47236 Operations and Maintenance Certificate English
F-47228 Report of Enforcement Methods English
F-47226 Report of Enforcement Methods (Part II) English
F-47225 Report of Enforcement Methods (Part 1) English
F-47223A Temporary Or Final Order Tag English
F-47222 Summary Suspension English
F-47219 Agent Change Sheet English
F-47217 Bed and Breakfast Inspection Report (PDF, 22 KB) English
F-47208A Additional Page for Recreational Sanitation English
F-47208 Recreational / Educational Camp Inspection Report English
F-47206 Campground Inspection Report English
F-47205 Swimming Pool Inspection Report (PDF, 929 KB) English
F-47204 Hazard Summary Form English
F-47198 Noise Exposure Sampling Sheet English
F-47181 First Responder Certification Card English
F-47141 Emergency Medical Technician-Paramedic Training Permit Application (PDF, 160 KB) English
F-47128 Emergency Medical Technician - Basic Training Permit Application (PDF, 711 KB) English
F-47125 Emergency Medical Technician - Intermediate Training Permit Application (PDF, 233 KB) English
F-47119 Ambulance Run Report (PDF, 110 KB) English
F-47097 Application for Registration of Ionizing Radiation Sources (PDF, 29 KB) English
F-47029 Monthly Swimming Pool Operation Report (PDF, 86 KB) English
F-47020 Sink Requirements English
F-47009 Hotel / Motel or Tourist Rooming House Inspection Report English
F-45038 Wisconsin Mercury Exposure Study English
F-45032 License, Permit or Registration - Radiation Only English
F-45031 Waterslide Inspection Report English
F-45030 Inspection Narrative English
F-45029i Instructions For School Food Safety Plan English
F-45029 School Food Safety Program Inspection Report English
F-45025 Patient Questionnaire English
F-45023 Certificate - Use of Depleted Uranium under General License (PDF, 308 KB) English
F-45022 Application for Material License English
F-45021 Generally Licensed Device Inspection by Mail English
F-45020 Cumulative Occupational Exposure History (PDF, 149 KB) English
F-45019 Reciprocity Privileges Checklist (PDF, 92 KB) English
F-45017 Application for Radioactive Material License Authorizing the Use of Sealed Sources English
F-45016 Application for a Radioactive Material License for Academic, Research and Development and Other Licenses of Limited Scope English

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Last Revised: July 28, 2017