All Income Maintenance (IM) Forms and Worksheets

Below is a list of all Income Maintenance (IM) forms and worksheets.

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

Assigned number	Title	Release date Sort ascending	File type	Language	Available to order
F-10112	Medicaid Disability Application	02/2026	PDF	English	Yes
F-10112S	Medicaid Disability Application, Spanish	02/2026	PDF	Spanish	No
F-10112H	Medicaid Disability Application, Hmong	02/2026	PDF	Hmong	No
F-10119A	Temporary Enrollment for Family Planning Only Services Application Instructions	02/2026	PDF	English	No
F-10081A	BadgerCare Plus - Express Enrollment for Pregnant Women Application Instructions	02/2026	PDF	English	No
F-10182DA	BadgerCare Plus Application Packet, Dari	01/2026	PDF	Dari (Afghan Persian)	No
F-10182	BadgerCare Plus Application Packet	01/2026	PDF	English	Yes
F-10182S	BadgerCare Plus Application Packet, Spanish	01/2026	PDF	Spanish	No
F-10182PA	BadgerCare Plus Application Packet, Pashto	01/2026	PDF	Pashto	No
F-10182H	BadgerCare Plus Application Packet, Hmong	01/2026	PDF	Hmong	No
F-10101S	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Spanish	01/2026	PDF	Spanish	No
F-10101	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet	01/2026	PDF	English	Yes
F-10101PA	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Pashto	01/2026	PDF	Pashto	No
F-10101H	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Hmong	01/2026	PDF	Hmong	No
F-10101DA	Wisconsin Medicaid for the Elderly, Blind, or Disabled Application Packet, Dari	01/2026	PDF	Dari (Afghan Persian)	No
F-13024	Medicaid Purchase Plan Premium - Employer Wage Withholding	01/2026	PDF	English	No
DMS-1004	2026 FoodShare Management Evaluation Review (MER) Customer Survey, English	01/2026	HTML	English	No
DMS-1006	2026 Management Evaluation Review (MER) Advocate Survey	01/2026	HTML	English	No
DMS-1005	2026 Management Evaluation Review (MER) Income Maintenance (IM) Staff Survey	01/2026	HTML	English	No
DMS-1003i	FoodShare Trafficking Claim Overpayment Worksheet Instructions	01/2026	PDF	English	No
DMS-1003	FoodShare Trafficking Claim Overpayment Worksheet	01/2026	Word	English	No
F-00476A	CARES Automated Systems Access Request Instructions	12/2025	PDF	English	No
F-00476	CARES Automated Systems Access Request	12/2025	PDF	English	No
F-16104	Customer Experience Survey	12/2025	PDF	English	Yes
F-16104H	Customer Experience Survey, Hmong	12/2025	PDF	Hmong	No

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