Forms Library

Forms produced by the Wisconsin Department of Health Services are available for downloading and printing. If a form is not available electronically, you will be provided instructions for requesting a paper copy. When you are searching for a form, just enter the number in the search box below.

Assigned Number Titlesort descending Division Other Location
F-01293C Fiscal Employer Agent (FEA) Change Effective Date Letter DMS
F-00161A Flowchart of Entity Investigation and Reporting Requirements for Caregiver Misconduct and Injuries of Unknown Source DQA
F-02491 FoodShare Buy and Make Food Separately DMS
F-01253 FoodShare Employment and Training (FSET) - Appointment Final Notice DMS
F-01256 FoodShare Employment and Training (FSET) - Discuss FSET Participation DMS
F-01254 FoodShare Employment and Training (FSET) - Employment Plan (EP) Appointment DMS
F-01252 FoodShare Employment and Training (FSET) - Initial Appointment DMS
F-01255 FoodShare Employment and Training (FSET) - Job Club Appointment DMS
F-01257 FoodShare Employment and Training (FSET) - Workshop Appointment DMS
F-00136 FoodShare Employment and Training (FSET) Program Participation Agreement DMS
F-16024 FoodShare Notice of Disqualification DMS
F-16076 FoodShare Six-Month Report and Instructions DMS
F-16066 FoodShare Wisconsin Income Change Report DMS
F-16073 FoodShare Wisconsin Nonfinancial Worksheet DMS
F-16019A FoodShare Wisconsin Registration DMS
F-16019B FoodShare Wisconsin Registration Packet DMS
F-16029 FoodShare Wisconsin Repayment Agreement DMS
F-16030 FoodShare Wisconsin Under / Overissuance Worksheet and Overpayment Calculator DMS
F-16033 FoodShare Worksheet DMS
F-80025A Forms / Publications Order OS
F-02493 ForwardHealth Prior Authorization Speech-Generating Device Purchase Recommendation Attachment DMS
F-02494 ForwardHealth Prior Authorization Speech-Generating Device Skills and Needs Profile Attachment DMS
F-01361 ForwardHealth Provider Express Enrollment Change of Address DMS
F-01016 ForwardHealth Provider Suggestion DMS
F-01999 Foster Grandparent Program: State Match Funding Application DPH
F-02614 Fraud Prevention and Investigation Program (FPIP) Fraud Year Contact Information OIG
F-01261 Fraud Statement - IRIS Program DMS
F-22553A Free In-Service or Educational Training Request DPH
F-00258 Functional Eligibility Screen - Mental Health and AODA (Co-Occurring) Services DCTS
F-00367 Functional Eligibility Screen for Children's Long-Term Support Programs DMS
F-01068F General Pediatric Clinic - 12 Month Visit DMS
F-01068G General Pediatric Clinic - 15 Month Visit DMS
F-01068H General Pediatric Clinic - 18 Month Visit DMS
F-01068i General Pediatric Clinic - 24 Month Visit DMS
F-01068A General Pediatric Clinic - 3 to 4 Week Visit DMS
F-01068C General Pediatric Clinic - 4 Month Visit DMS
F-01068D General Pediatric Clinic - 6 Month Visit DMS
F-01068B General Pediatric Clinic - 6 to 8 Week Visit DMS
F-01068E General Pediatric Clinic - 9 Month Visit DMS
F-01068K General Pediatric Clinic - Elementary School Visit DMS
F-01068J General Pediatric Clinic - Preschool Visit DMS
F-01068L General Pediatric Clinic - Teenager Visit DMS
F-45021 Generally Licensed Device Inspection by Mail DPH
F-10111 Good Faith Medicaid / BadgerCare Plus Certification DMS
F-01212 Grievance - IRIS Program DMS
F-02726 Hand Hygiene (HH) and Personal Protective Equipment (PPE) Observations DPH
F-02475 Hand Hygiene Observations DPH
F-02382 HCBS Heightened Scrutiny Residential Provider Evidentiary Worksheet DMS
F-02383 HCBS Heightened Scrutiny Reviewer Assessment and Evidentiary Summary DMS
F-02605A HCBS Settings Rule: Heightened Scrutiny Settings Review – Evidentiary Document Checklist DMS

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Last Revised: March 23, 2021