Skip to main content

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-16039SO Waiver of Administrative Disqualification Hearing, Somali DMS Somali 07/2023 PDF No
F-16039S Waiver of Administrative Disqualification Hearing, Spanish DMS Spanish 07/2023 PDF No
F-62369 Waiver of Hospice or Home Health Services by a Terminally Ill Resident of a Community Based Residential Facility (CBRF) DQA English 04/2009 PDF No
F-62369 Waiver of Hospice or Home Health Services by a Terminally Ill Resident of a Community Based Residential Facility (CBRF) DQA English 04/2009 Word No
F-62369S Waiver of Hospice or Home Health Services by a Terminally Ill Resident of a Community Based Residential Facility (CBRF), Spanish DQA Spanish 04/2009 PDF No
F-62369S Waiver of Hospice or Home Health Services by a Terminally Ill Resident of a Community Based Residential Facility (CBRF), Spanish DQA Spanish 04/2009 Word No
F-60289 Waiver or Variance Request - Community Mental Health and Substance Abuse Treatment Services DQA English 09/2023 Word No
F-03039 WCESIL Membership Agreement DPH English 05/2022 HTML No
F-01302 Weekly Driver's Vehicle Inspection Report DMS English 09/2019 PDF No
F-01302 Weekly Driver's Vehicle Inspection Report DMS English 09/2019 Word No
F-01302A Weekly Driver's Vehicle Inspection Report Completion Instructions DMS English 07/2012 PDF No
F-02007 WI HPP Exercise and Real Event Report DPH English 06/2022 HTML No
F-03025 WI Tribal Health Department: Diabetes Prevention Funding Progress Report DPH English 03/2023 HTML No
F-03076 WI Vaccine 3rd Party Scheduling Tracker DPH English 08/2022 HTML No
F-03075 WI Vaccine Support- All Calls Tracker DPH English 07/2022 HTML No
F-01821 WIC Authorized Infant Formula Supplier Application DPH English 04/2022 Word No
F-44161A WIC Cardholder Rights and Responsibilities DPH English 08/2023 PDF No
F-44161AH WIC Cardholder Rights and Responsibilities, Hmong DPH Hmong 08/2023 PDF No
F-44161AS WIC Cardholder Rights and Responsibilities, Spanish DPH Spanish 08/2023 PDF No
F-03043 WIC Medical Formula Order DPH English 06/2022 HTML No
F-02040 WIC Program Notice of Categorical Ineligibility DPH English 08/2023 Word No
F-02040H WIC Program Notice of Categorical Ineligibility, Hmong DPH Hmong 08/2023 Word No
F-02040S WIC Program Notice of Categorical Ineligibility, Spanish DPH Spanish 08/2023 Word No
F-40085 WIC Program Notice of Ineligibility DPH English 08/2023 Word No
F-40085 WIC Program Notice of Ineligibility DPH English 08/2023 PDF No
F-40085H WIC Program Notice of Ineligibility, Hmong DPH Hmong 08/2023 PDF No
F-40085S WIC Program Notice of Ineligibility, Spanish DPH Spanish 08/2023 PDF No
F-44024A WIC Request for Medical Food: Pregnant, Breastfeeding, and Nonbreastfeeding Postpartum Women DPH English 06/2023 Word No
F-44024D WIC Request for Medical Formula/Food: Infants and Children DPH English 09/2024 Word No
F-44161 WIC Rights and Responsibilities DPH English 07/2023 HTML No
F-44161 WIC Rights and Responsibilities DPH English 07/2023 PDF No
F-44161AL WIC Rights and Responsibilities, Albanian DPH Albanian 07/2023 PDF No
F-44161AL WIC Rights and Responsibilities, Albanian DPH Albanian 07/2023 HTML No
F-44161AR WIC Rights and Responsibilities, Arabic DPH Arabic 07/2023 PDF No
F-44161AR WIC Rights and Responsibilities, Arabic DPH Arabic 07/2023 HTML No
F-44161BU WIC Rights and Responsibilities, Burmese DPH Burmese 07/2023 PDF No
F-44161BU WIC Rights and Responsibilities, Burmese DPH Burmese 07/2023 HTML No
F-44161CM WIC Rights and Responsibilities, Chinese (Simplified) DPH Chinese (Simplified) 07/2023 PDF No
F-44161CC WIC Rights and Responsibilities, Chinese (Traditional) DPH Chinese (Traditional) 07/2023 HTML No
F-44161CC WIC Rights and Responsibilities, Chinese (Traditional) DPH Chinese (Traditional) 07/2023 PDF No
F-44161CM WIC Rights and Responsibilities, Chinese Mandarin DPH Chinese (Simplified) 07/2023 HTML No
F-44161DA WIC Rights and Responsibilities, Dari DPH Dari (Afghan Persian) 07/2023 HTML No
F-44161DA WIC Rights and Responsibilities, Dari DPH Dari (Afghan Persian) 07/2023 PDF No
F-44161FR WIC Rights and Responsibilities, French DPH French 07/2023 HTML No
F-44161FR WIC Rights and Responsibilities, French DPH French 07/2023 PDF No
F-44161HT WIC Rights and Responsibilities, Haitian Creole DPH Haitian Creole 07/2023 PDF No
F-44161HT WIC Rights and Responsibilities, Haitian Creole DPH Haitian Creole 07/2023 HTML No
F-44161H WIC Rights and Responsibilities, Hmong DPH Hmong 07/2023 PDF No
F-44161H WIC Rights and Responsibilities, Hmong DPH Hmong 07/2023 HTML No
F-44161KA WIC Rights and Responsibilities, Karen DPH Karen 07/2023 HTML 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.

Glossary

 
Last revised December 4, 2024