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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 Available to order
F-02782R Coalition to End Social Isolation and Loneliness - Stakeholder Engagement Survey, Russian (HTML) DPH Russian 03/2021 No
F-02782S Coalition to End Social Isolation and Loneliness - Stakeholder Engagement Survey, Spanish (HTML) DPH Spanish 03/2021 No
F-22687 Collaborative Systems of Care (CSOC) Plan of Care (PDF) DCTS English 03/2017 No
F-22685 Collaborative Systems of Care (CSOC) Summary of Strengths and Needs Assessment (PDF) DCTS English 11/2016 No
F-01159 Commercial Other Coverage Discrepancy Report (PDF) DMS English 04/2017 No
F-01159 Commercial Other Coverage Discrepancy Report (Word) DMS English 04/2017 No
F-01159A Commercial Other Coverage Discrepancy Report Instructions (PDF) DMS English 04/2017 No
F-01679 Communicable Disease / Tuberculosis Screening Questionnaire (Word) DQA English 12/2015 No
F-01679S Communicable Disease / Tuberculosis Screening Questionnaire, Spanish (Word) DQA Spanish 12/2015 No
F-00043 Communication to Local Educational Agency Regarding Child Referral (Word) DMS English 02/2017 No
F-60367 Community Advisory Committee Documentation (PDF) DQA English 09/2026 No
F-60290 Community Based Residential Facility (CBRF) Identification of Hazards Request (Word) DQA English 09/2026 No
F-62372 Community Based Residential Facility (CBRF) Resident Satisfaction Evaluation (Word) DQA English 11/2012 No
F-62372 Community Based Residential Facility (CBRF) Resident Satisfaction Evaluation (PDF) DQA English 11/2012 No
F-62372S Community Based Residential Facility (CBRF) Resident Satisfaction Evaluation, Spanish (PDF) DQA Spanish 11/2012 No
F-62372S Community Based Residential Facility (CBRF) Resident Satisfaction Evaluation, Spanish (Word) DQA Spanish 11/2012 No
F-62430 Community Based Residential Facility (CBRF) Residents' Rights Complaint Report (PDF) DQA English 04/2009 No
F-62430 Community Based Residential Facility (CBRF) Residents' Rights Complaint Report (Word) DQA English 04/2009 No
F-02941 Community Engagement Assessment Tool (Simplified) (HTML) DPH English 01/2022 No
F-03134 Community Engagement Assessment Tool - Results (HTML) DPH English 03/2023 No
F-02681A Community Engagement Assessment Tool Request (HTML) DPH English 06/2020 No
F-00203 Community Recovery Services (CRS) - County / Tribal Agency Application (Word) DCTS English 07/2024 No
F-02565 Community Recovery Services (CRS) Staff Background Check Confirmation (Word) DCTS English 10/2019 No
F-10096 Community Spouse Asset Share (PDF) DMS English 07/2008 No
F-10096S Community Spouse Asset Share, Spanish (PDF) DMS Spanish 07/2008 No
F-10097A Community-Based Long-Term Care Services Medicaid Income Allocation (PDF) DMS English 06/2022 No
F-10097AH Community-Based Long-Term Care Services Medicaid Income Allocation, Hmong (PDF) DMS Hmong 06/2022 No
F-10097AS Community-Based Long-Term Care Services Medicaid Income Allocation, Spanish (PDF) DMS Spanish 06/2022 No
F-02634B Community-Based Residential Facility (CBRF) Initial Survey Checklist (Word) DQA English 07/2026 No
F-02778 Community-Based Vaccination Clinic Request for Dedicated Vaccine Supply (PDF) DPH English 03/2021 No
F-62495 Compliance Statement (PDF) DQA English 08/2020 No
F-62495 Compliance Statement (Word) DQA English 08/2020 No
F-13073 Compound Drug Claim (PDF) DMS English 04/2017 No
F-13073 Compound Drug Claim (Word) DMS English 04/2017 No
F-13073A Compound Drug Claim: Completion Instructions (PDF) DMS English 02/2025 No
F-01216 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders Regional Model Supplemental Application DHS 36 (Word) DQA English 05/2014 No
F-01216 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders Regional Model Supplemental Application DHS 36 (PDF) DQA English 05/2014 No
F-02759 Comprehensive Community Services Cost Settlement Advance Request (Word) DMS English 01/2026 No
F-01270 Comprehensive Community Services Non-Traditional Approval (PDF) DMS English 07/2014 No
F-01270 Comprehensive Community Services Non-Traditional Approval (Word) DMS English 07/2014 No
F-25614 Conditional Release Rules and Conditions (Word) DCTS English 09/2026 No
F-25614H Conditional Release Rules and Conditions, Hmong (Word) DCTS Hmong 09/2026 No
F-25614S Conditional Release Rules and Conditions, Spanish (Word) DCTS Spanish 09/2026 No
F-40054 Confidential Birth Defect Registry Report (PDF) DPH English 02/2026 No
F-01068M Confidential Health Survey (PDF) DMS English 08/2019 No
F-01068M Confidential Health Survey (Word) DMS English 08/2019 No
F-01068MS Confidential Health Survey, Spanish (PDF) DMS Spanish 08/2019 No
F-01068MS Confidential Health Survey, Spanish (Word) DMS Spanish 08/2019 No
F-82009 Confidential Information Release Authorization (Word) OLC English 07/2008 No
F-82009 Confidential Information Release Authorization (PDF) OLC English 07/2008 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