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 Sort descending Division Language Release date Available to order
F-00974 Agreement Between State of Wisconsin Department of Health Services - WIC and Senior Farmers' Market Nutrition Program (FMNP) (PDF) DPH English 03/2026
F-40036 Agreement Between the State of Wisconsin and the Wisconsin Women, Infant, and Children (WIC) Vendor (Word) DPH English 11/2025
F-40036 Agreement Between the State of Wisconsin and the Wisconsin Women, Infant, and Children (WIC) Vendor (PDF) DPH English 11/2025
F-03151 AIDS Service Organization Designation Request (PDF) DPH English 09/2026
F-01571 Air Quality Measurement Device Maintenance and Calibration Log (Word) DPH English 06/2015
F-62617 Alleged Nursing Home Resident Mistreatment, Neglect and Abuse Report (Word) DQA English 03/2024
F-02659 Alternate Electronic Visit Verification (EVV) Attestation (PDF) DMS English 08/2023
F-21343E Alzheimer’s Family Caregiver Support Program (AFCSP) Enrollment (Word) DPH English 08/2025
F-21343ES Alzheimer’s Family Caregiver Support Program (AFCSP) Enrollment, Spanish (Word) DPH Spanish 08/2025
F-47247 Ambulance Attendant License/Permit Renew (HTML) DPH English 08/2010
F-03328 American Sign Language (ASL) Interpreter and Captioning Request (HTML) DPH English 11/2024
F-62502 Analyst Application to Perform Alcohol, Controlled Substance, and Controlled Substance Analog Testing (PDF) DQA English 05/2026
F-02817 Annual Review for Division of Medicaid Services (DMS) Vendors (Word) DMS English 08/2026
F-40093 Annual ROSIE User Security and Confidentiality Agreement (PDF) DPH English 07/2026
F-00913 Annual Survey of Intermediate Care Facilities - 2025 (Word) DQA English 02/2026
F-44126 Antituberculosis Therapy Program Medication Refill Request (PDF) DPH English 02/2024
F-00237 Appeal Request - MCOs - Anthem (Word) DMS English 05/2026
F-00237AR Appeal Request - MCOs - Anthem, Arabic (Word) DMS Arabic 05/2026
F-00237BU Appeal Request - MCOs - Anthem, Burmese (Word) DMS Burmese 05/2026
F-00237CM Appeal Request - MCOs - Anthem, Chinese (Simplified) (Word) DMS Chinese (Simplified) 05/2026
F-00237H Appeal Request - MCOs - Anthem, Hmong (Word) DMS Hmong 05/2026
F-00237L Appeal Request - MCOs - Anthem, Laotian (Word) DMS Lao 05/2026
F-00237R Appeal Request - MCOs - Anthem, Russian (Word) DMS Russian 05/2026
F-00237SO Appeal Request - MCOs - Anthem, Somali (Word) DMS Somali 05/2026
F-00237S Appeal Request - MCOs - Anthem, Spanish (Word) DMS Spanish 05/2026
F-00237UK Appeal Request - MCOs - Anthem, Ukrainian (Word) DMS Ukrainian 05/2026
F-00237V Appeal Request - MCOs - Anthem, Vietnamese (Word) DMS Vietnamese 05/2026
F-00237 Appeal Request - MCOs - Community Care Inc. (Word) DMS English 05/2026
F-00237AR Appeal Request - MCOs - Community Care Inc., Arabic (Word) DMS Arabic 05/2026
F-00237BU Appeal Request - MCOs - Community Care Inc., Burmese (Word) DMS Burmese 05/2026
F-00237CM Appeal Request - MCOs - Community Care Inc., Chinese (Simplified) (Word) DMS Chinese (Simplified) 05/2026
F-00237H Appeal Request - MCOs - Community Care Inc., Hmong (Word) DMS Hmong 05/2026
F-00237L Appeal Request - MCOs - Community Care Inc., Laotian (Word) DMS Lao 05/2026
F-00237R Appeal Request - MCOs - Community Care Inc., Russian (Word) DMS Russian 05/2026
F-00237SO Appeal Request - MCOs - Community Care Inc., Somali (Word) DMS Somali 05/2026
F-00237S Appeal Request - MCOs - Community Care Inc., Spanish (Word) DMS Spanish 05/2026
F-00237UK Appeal Request - MCOs - Community Care Inc., Ukrainian (Word) DMS Ukrainian 05/2026
F-00237V Appeal Request - MCOs - Community Care Inc., Vietnamese (Word) DMS Vietnamese 05/2026
F-00237 Appeal Request - MCOs - Inclusa (Word) DMS English 09/2026
F-00237AR Appeal Request - MCOs - Inclusa, Arabic (Word) DMS Arabic 09/2026
F-00237BU Appeal Request - MCOs - Inclusa, Burmese (Word) DMS Burmese 09/2026
F-00237CM Appeal Request - MCOs - Inclusa, Chinese (Simplified) (Word) DMS Chinese (Simplified) 09/2026
F-00237H Appeal Request - MCOs - Inclusa, Hmong (Word) DMS Hmong 09/2026
F-00237L Appeal Request - MCOs - Inclusa, Laotian (Word) DMS Lao 09/2026
F-00237R Appeal Request - MCOs - Inclusa, Russian (Word) DMS Russian 09/2026
F-00237SO Appeal Request - MCOs - Inclusa, Somali (Word) DMS Somali 09/2026
F-00237S Appeal Request - MCOs - Inclusa, Spanish (Word) DMS Spanish 09/2026
F-00237UK Appeal Request - MCOs - Inclusa, Ukrainian (Word) DMS Ukrainian 09/2026
F-00237V Appeal Request - MCOs - Inclusa, Vietnamese (Word) DMS Vietnamese 09/2026
F-00237 Appeal Request - MCOs - Independent Care Health Plan (Word) DMS English 05/2026

Glossary

 
Last revised October 27, 2025