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 File Type Available to Order
F-00163 Prior Authorization Drug Attachment for Anti-Obesity Drugs DMS English 07/2024 PDF
F-00163 Prior Authorization Drug Attachment for Anti-Obesity Drugs DMS English 07/2024 Word
F-00163A Prior Authorization Drug Attachment for Anti-Obesity Drugs Instructions DMS English 07/2024 PDF
F-00194 Prior Authorization Drug Attachment for Antiemetics, Cannabinoids DMS English 07/2021 PDF
F-00194 Prior Authorization Drug Attachment for Antiemetics, Cannabinoids DMS English 07/2021 Word
F-00194A Prior Authorization Drug Attachment for Antiemetics, Cannabinoids, Instructions DMS English 07/2021 PDF
F-00556 Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger DMS English 01/2018 PDF
F-00556 Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger DMS English 01/2018 Word
F-00556A Prior Authorization Drug Attachment for Antipsychotic Drugs for Children 8 Years of Age and Younger Instructions DMS English 01/2018 PDF
F-11304 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Ankylosing Spondylitis DMS English 01/2025 PDF
F-11304 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Ankylosing Spondylitis DMS English 01/2025 Word
F-01950 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Crohn's Disease and Ulcerative Colitis DMS English 01/2025 Word
F-01950 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Crohn's Disease and Ulcerative Colitis DMS English 01/2025 PDF
F-01952 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis DMS English 01/2025 Word
F-01952 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis DMS English 01/2025 PDF
F-01952A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) Antagonist Drugs for Giant Cell Arteritis and Non-Radiographic Axial Spondyloarthritis Instructions DMS English 01/2025 PDF
F-11304A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Ankylosing Spondylitis Instructions DMS English 01/2025 PDF
F-01950A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Crohn’s Disease and Ulcerative Colitis Instructions DMS English 01/2025 PDF
F-03174 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa DMS English 01/2025 Word
F-03174 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa DMS English 01/2025 PDF
F-03174A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Hidradenitis Suppurativa Instructions DMS English 01/2025 PDF
F-11306 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Psoriasis DMS English 01/2025 Word
F-11306 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Psoriasis DMS English 01/2025 PDF
F-11306A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Psoriasis Instructions DMS English 01/2025 PDF
F-01951 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA), and Psoriatic Arthritis DMS English 01/2025 PDF
F-01951 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA), and Psoriatic Arthritis DMS English 01/2025 Word
F-01951A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA), and Psoriatic Arthritis Instructions DMS English 01/2025 PDF
F-03224 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Uveitis DMS English 01/2025 Word
F-03224 Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Uveitis DMS English 01/2025 PDF
F-03224A Prior Authorization Drug Attachment for Cytokine and Cell Adhesion Molecule (CAM) for Uveitis Instructions DMS English 01/2025 PDF
F-02666 Prior Authorization Drug Attachment for Headache Agents, Acute Treatment DMS English 07/2022 PDF
F-02666 Prior Authorization Drug Attachment for Headache Agents, Acute Treatment DMS English 07/2022 Word
F-02666A Prior Authorization Drug Attachment for Headache Agents, Acute Treatment Instructions DMS English 07/2022 PDF
F-02667 Prior Authorization Drug Attachment for Headache Agents, Preventative Treatment DMS English 07/2022 PDF
F-02667 Prior Authorization Drug Attachment for Headache Agents, Preventative Treatment DMS English 07/2022 Word
F-02667A Prior Authorization Drug Attachment for Headache Agents, Preventative Treatment Instructions DMS English 07/2022 PDF
F-01247 Prior Authorization Drug Attachment for Hepatitis C Agents DMS English 07/2020 Word
F-01247 Prior Authorization Drug Attachment for Hepatitis C Agents DMS English 07/2020 PDF
F-01247A Prior Authorization Drug Attachment for Hepatitis C Agents Instructions DMS English 07/2020 PDF
F-01248 Prior Authorization Drug Attachment for Hepatitis C Agents Renewal DMS English 08/2016 PDF
F-00238 Prior Authorization Drug Attachment for Hypoglycemics, Glucagon-Like Peptide (GLP-1) Agents DMS English 07/2024 Word
F-00238 Prior Authorization Drug Attachment for Hypoglycemics, Glucagon-Like Peptide (GLP-1) Agents DMS English 07/2024 PDF
F-00238A Prior Authorization Drug Attachment for Hypoglycemics, Glucagon-Like Peptide (GLP-1) Agents Instructions DMS English 07/2024 PDF
F-01749 Prior Authorization Drug Attachment for Hypoglycemics, Insulins Long-Acting DMS English 07/2024 Word
F-01749 Prior Authorization Drug Attachment for Hypoglycemics, Insulins Long-Acting DMS English 07/2024 PDF
F-01749A Prior Authorization Drug Attachment for Hypoglycemics, Insulins Long-Acting Instructions DMS English 07/2024 PDF
F-00162 Prior Authorization Drug Attachment for Lipotropics, Omega-3 Acids DMS English 07/2024 PDF
F-00162 Prior Authorization Drug Attachment for Lipotropics, Omega-3 Acids DMS English 07/2024 Word
F-00162A Prior Authorization Drug Attachment for Lipotropics, Omega-3 Acids Instructions DMS English 07/2024 PDF
F-02505 Prior Authorization Drug Attachment for Lipotropics, Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors DMS English 07/2024 PDF

Glossary

 
Last revised December 4, 2024