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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 File Type Available to Order
F-02681A Community Engagement Assessment Tool Request DPH English 06/2020 HTML No
F-02681 Community Engagement Assessment Tool Survey DPH English 06/2020 PDF No
F-01684 Community Mental Health Allocation (CMHA) Report DCTS English 01/2023 HTML No
F-00203 Community Recovery Services (CRS) - County / Tribal Agency Application DCTS English 07/2024 Word No
F-02565 Community Recovery Services (CRS) Staff Background Check Confirmation DCTS English 10/2019 Word No
F-10096 Community Spouse Asset Share DMS English 07/2008 PDF No
F-10096S Community Spouse Asset Share, Spanish DMS Spanish 07/2008 PDF No
F-00546 Community Support Program (CSP) for Persons with Chronic Mental Illness Initial Certification Application - DHS 63 DQA English 12/2011 Word No
F-00546 Community Support Program (CSP) for Persons with Chronic Mental Illness Initial Certification Application - DHS 63 DQA English 12/2011 PDF No
F-02704 Community Testing Support Program Application DPH English 10/2021 Excel No
F-10097A Community-Based Long-Term Care Services Medicaid Income Allocation DMS English 06/2022 PDF No
F-10097AH Community-Based Long-Term Care Services Medicaid Income Allocation, Hmong DMS Hmong 06/2022 PDF No
F-10097AS Community-Based Long-Term Care Services Medicaid Income Allocation, Spanish DMS Spanish 06/2022 PDF No
F-02634B Community-Based Residential Facility (CBRF) Initial Survey Checklist DQA English 03/2020 Word No
F-02778 Community-Based Vaccination Clinic Request for Dedicated Vaccine Supply DPH English 03/2021 PDF No
F-01945 Compliance Assistance Checklist DPH English 11/2016 PDF No
F-62495 Compliance Statement DQA English 08/2020 PDF No
F-62495 Compliance Statement DQA English 08/2020 Word No
F-13073 Compound Drug Claim DMS English 04/2017 Word No
F-13073 Compound Drug Claim DMS English 04/2017 PDF No
F-13073A Compound Drug Claim: Completion Instructions DMS English 04/2017 PDF No
F-00482 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders Initial Certification Application - Chapter DHS 36 DQA English 05/2016 PDF No
F-00482 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders Initial Certification Application - Chapter DHS 36 DQA English 05/2016 Word No
F-01216 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders Regional Model Supplemental Application DHS 36 DQA English 05/2014 Word No
F-01216 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders Regional Model Supplemental Application DHS 36 DQA English 05/2014 PDF No
F-00475 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders: Recertification Application - DHS 36 DQA English 08/2015 Word No
F-00475 Comprehensive Community Services (CCS) for Persons with Mental Disorders and Substance Use Disorders: Recertification Application - DHS 36 DQA English 08/2015 PDF No
F-02759 Comprehensive Community Services Cost Settlement Advance Request DMS English 01/2025 Word No
F-01270 Comprehensive Community Services Non-Traditional Approval DMS English 07/2014 Word No
F-01270 Comprehensive Community Services Non-Traditional Approval DMS English 07/2014 PDF No
F-25614 Conditional Release Rules and Conditions DCTS English 01/2017 PDF No
F-25614 Conditional Release Rules and Conditions DCTS English 01/2017 Word No
F-25614H Conditional Release Rules and Conditions, Hmong DCTS Hmong 01/2017 PDF No
F-25614H Conditional Release Rules and Conditions, Hmong DCTS Hmong 01/2017 Word No
F-25614S Conditional Release Rules and Conditions, Spanish DCTS Spanish 01/2017 PDF No
F-25614S Conditional Release Rules and Conditions, Spanish DCTS Spanish 01/2017 Word No
F-40054A Confidential Birth Defects Registry - Request to Remove Identifiers DPH English 01/2018 PDF No
F-40054AS Confidential Birth Defects Registry - Request to Remove Identifiers, Spanish DPH Spanish 01/2018 PDF No
F-40054 Confidential Birth Defects Registry Report DPH English 12/2023 Word No
F-40054 Confidential Birth Defects Registry Report DPH English 12/2023 PDF No
F-01068M Confidential Health Survey DMS English 08/2019 Word No
F-01068M Confidential Health Survey DMS English 08/2019 PDF No
F-01068MS Confidential Health Survey, Spanish DMS Spanish 08/2019 PDF No
F-01068MS Confidential Health Survey, Spanish DMS Spanish 08/2019 Word No
F-82009 Confidential Information Release Authorization DES English 07/2008 PDF No
F-82009 Confidential Information Release Authorization DES English 07/2008 Word No
F-82009BU Confidential Information Release Authorization, Burmese DES Burmese 07/2008 PDF No
F-82009H Confidential Information Release Authorization, Hmong DES Hmong 07/2008 PDF No
F-82009RU Confidential Information Release Authorization, Russian DES Russian 07/2008 PDF No
F-82009S Confidential Information Release Authorization, Spanish DES Spanish 07/2008 PDF 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 December 4, 2024