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BadgerCare Plus Forms

Below is a list of all BadgerCare Plus forms. 

When you are searching for a document, enter the number or a portion of the title in the search box below.

Assigned number Title Division Language Release date Available to order
F-00080A Prior Authorization / Preferred Drug List (PA/PDL) for Symlin Completion Instructions (PDF) DMS English 07/2015 No
F-11031 Prior Authorization / Psychotherapy Attachment (PA/PSYA) (Word) DMS English 07/2012 No
F-11031 Prior Authorization / Psychotherapy Attachment (PA/PSYA) (PDF) DMS English 07/2012 No
F-11031A Prior Authorization / Psychotherapy Attachment (PA/PSYA) Completion Instructions (PDF) DMS English 10/2008 No
F-11032 Prior Authorization / Substance Abuse Attachment (PA/SAA) (Word) DMS English 07/2012 No
F-11032 Prior Authorization / Substance Abuse Attachment (PA/SAA) (PDF) DMS English 07/2012 No
F-11032A Prior Authorization / Substance Abuse Attachment (PA/SAA) Completion Instructions (PDF) DMS English 10/2008 No
F-11008 Prior Authorization / Therapy Attachment (PA/TA) (PDF) DMS English 12/2025 No
F-11008 Prior Authorization / Therapy Attachment (PA/TA) (Word) DMS English 12/2025 No
F-11051 Prior Authorization / Vision Services Attachment (PA/VA) (PDF) DMS English 08/2026 No
F-11051 Prior Authorization / Vision Services Attachment (PA/VA) (Word) DMS English 08/2026 No
F-11042 Prior Authorization Amendment Request (Word) DMS English 07/2012 No
F-11042 Prior Authorization Amendment Request (PDF) DMS English 07/2012 No
F-11042A Prior Authorization Amendment Request Completion Instructions (PDF) DMS English 07/2012 No
F-11035 Prior Authorization Dental Request Form (PA/DRF) (PDF) DMS English 06/2024 No
F-11035 Prior Authorization Dental Request Form (PA/DRF) (Word) DMS English 06/2024 No
F-11035A Prior Authorization Dental Request Form (PA/DRF) Instructions (PDF) DMS English 06/2024 No
F-00194 Prior Authorization Drug Attachment for Antiemetics, Cannabinoids (PDF) DMS English 07/2021 No
F-00194 Prior Authorization Drug Attachment for Antiemetics, Cannabinoids (Word) DMS English 07/2021 No
F-00194A Prior Authorization Drug Attachment for Antiemetics, Cannabinoids, Instructions (PDF) DMS English 07/2021 No
F-00556 Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger (PDF) DMS English 01/2018 No
F-00556 Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger (Word) DMS English 01/2018 No
F-00556A Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger Instructions (PDF) DMS English 01/2018 No
F-01950 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Crohn’s Disease and Ulcerative Colitis (Word) DMS English 07/2026 No
F-01950 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Crohn’s Disease and Ulcerative Colitis (PDF) DMS English 07/2026 No
F-01950A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Crohn’s Disease and Ulcerative Colitis Instructions (PDF) DMS English 07/2026 No
F-01952 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis (nr-axSpA) (Word) DMS English 01/2026 No
F-01952 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis (nr-axSpA) (PDF) DMS English 01/2026 No
F-01952A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis (nr-axSpA) Instructions (PDF) DMS English 01/2026 No
F-03224 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Oral Ulcers Associated With Behcet’s Disease and Uveitis (Word) DMS English 01/2026 No
F-03224 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Oral Ulcers Associated With Behcet’s Disease and Uveitis (PDF) DMS English 01/2026 No
F-03224A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Oral Ulcers Associated With Behcet’s Disease and Uveitis Instructions (PDF) DMS English 01/2026 No
F-11306 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Psoriasis (Word) DMS English 07/2026 No
F-11306 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Psoriasis (PDF) DMS English 07/2026 No
F-11306A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Psoriasis Instructions (PDF) DMS English 07/2026 No
F-01951 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA), and Psoriatic Arthritis (Word) DMS English 07/2026 No
F-01951 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA), and Psoriatic Arthritis (PDF) DMS English 07/2026 No
F-01951A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA), and Psoriatic Arthritis Instructions (PDF) DMS English 07/2026 No
F-11304 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Ankylosing Spondylitis (Word) DMS English 01/2026 No
F-11304 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Ankylosing Spondylitis (PDF) DMS English 01/2026 No
F-11304A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Ankylosing Spondylitis Instructions (PDF) DMS English 01/2026 No
F-03174 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa (Word) DMS English 01/2026 No
F-03174 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa (PDF) DMS English 01/2026 No
F-03174A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa Instructions (PDF) DMS English 01/2026 No
F-01247 Prior Authorization Drug Attachment for Hepatitis C Agents (Word) DMS English 07/2020 No
F-01247 Prior Authorization Drug Attachment for Hepatitis C Agents (PDF) DMS English 07/2020 No
F-01247A Prior Authorization Drug Attachment for Hepatitis C Agents Instructions (PDF) DMS English 07/2020 No
F-00238 Prior Authorization Drug Attachment for Hypoglycemics, Glucagon-Like Peptide (GLP-1) Agents (PDF) DMS English 07/2025 No
F-00238 Prior Authorization Drug Attachment for Hypoglycemics, Glucagon-Like Peptide (GLP-1) Agents (Word) DMS English 07/2025 No
F-00238A Prior Authorization Drug Attachment for Hypoglycemics, Glucagon-Like Peptide (GLP-1) Agents Instructions (PDF) DMS English 07/2025 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 September 30, 2025