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-16022S Social Security Number Referral, Spanish DMS Spanish 07/2008 PDF
F-01345 Special Care Environment Working Document DPH English 09/2016 Word
F-11296 Specialized Medical Vehicle (SMV) Transportation Service Informational OIG English 07/2012 PDF
F-00885 Specialized Medical Vehicle Insurance Documentation Checklist DMS English 03/2014 PDF
F-00885 Specialized Medical Vehicle Insurance Documentation Checklist DMS English 03/2014 Word
F-11237 Specialized Medical Vehicle Providers Affidavit DMS English 01/2022 PDF
F-11237 Specialized Medical Vehicle Providers Affidavit DMS English 01/2022 Word
F-01050 Specialized Medical Vehicle Transportation Trip Ticket / Medical Care Verification DMS English 04/2022 PDF
F-01050A Specialized Medical Vehicle Transportation Trip Ticket / Medical Care Verification Completion Instructions DMS English 04/2022 PDF
F-01104 Specialized Psychiatric Rehabilitation Services (SPRS) Monthly Roster DMS English 02/2025 Excel
F-01306 Spousal Impoverishment Income Allocation Worksheet DMS English 07/2014 PDF
F-20812 SSI-E Natural Residential Setting Application Checklist DMS English 09/2019 PDF
F-20812 SSI-E Natural Residential Setting Application Checklist DMS English 09/2019 Word
F-11055 STAT-PA System Instructions DMS English 07/2015 PDF
F-00030 State and Specialty Maximum Allowed Cost Drug Pricing Review Request DMS English 04/2017 Word
F-00030 State and Specialty Maximum Allowed Cost Drug Pricing Review Request DMS English 04/2017 PDF
F-00030A State and Specialty Maximum Allowed Cost Drug Pricing Review Request: Completion Instructions DMS English 04/2017 PDF
F-00100 State Vital Records Birth Certificate Request Letter DMS English 06/2019 Word
F-02430 Statement About Immigration Status DMS English 03/2019 PDF
F-02430DA Statement About Immigration Status, Dari DMS Dari (Afghan Persian) 03/2019 PDF
F-02430H Statement About Immigration Status, Hmong DMS Hmong 03/2019 PDF
F-02430PA Statement About Immigration Status, Pashto DMS Pashto 03/2019 PDF
F-02430S Statement About Immigration Status, Spanish DMS Spanish 03/2019 PDF
F-02431 Statement About U.S. Military Service DMS English 06/2023 PDF
F-02431AR Statement About U.S. Military Service, Arabic DMS Arabic 06/2023 PDF
F-02431BU Statement About U.S. Military Service, Burmese DMS Burmese 06/2023 PDF
F-02431CM Statement About U.S. Military Service, Chinese (Simplified) DMS Chinese (Simplified) 06/2023 PDF
F-02431G Statement About U.S. Military Service, German DMS German 06/2023 PDF
F-02431H Statement About U.S. Military Service, Hmong DMS Hmong 06/2023 PDF
F-02431L Statement About U.S. Military Service, Laotian DMS Laotian 06/2023 PDF
F-02431R Statement About U.S. Military Service, Russian DMS Russian 06/2023 PDF
F-02431SO Statement About U.S. Military Service, Somali DMS Somali 06/2023 PDF
F-02431S Statement About U.S. Military Service, Spanish DMS Spanish 06/2023 PDF
F-10161 Statement of Citizenship and/or Identity DMS English 07/2018 PDF
F-10154 Statement of Identity for Children Under 18 Years of Age DMS English 07/2008 PDF
F-10154DA Statement of Identity for Children Under 18 Years of Age, Dari DMS Dari (Afghan Persian) 07/2008 PDF
F-10154H Statement of Identity for Children Under 18 Years of Age, Hmong DMS Hmong 07/2008 PDF
F-10154PA Statement of Identity for Children Under 18 Years of Age, Pashto DMS Pashto 07/2008 PDF
F-10154R Statement of Identity for Children Under 18 Years of Age, Russian DMS Russian 07/2008 PDF
F-10154S Statement of Identity for Children Under 18 Years of Age, Spanish DMS Spanish 07/2008 PDF
F-10175 Statement of Identity for Persons in Institutional Care Facilities DMS English 06/2023 PDF
F-25177 Statement of Probable Cause and Detention and Petition for Revocation DCTS English 03/2021 PDF
F-25177 Statement of Probable Cause and Detention and Petition for Revocation DCTS English 03/2021 Word
F-00685 Statement of Tribal Affiliation DMS English 06/2023 PDF
F-01809 Statewide Naloxone Signup (RedCap) DPH English 08/2016 HTML
F-01802 Statewide Naloxone Standing Order for Pharmacist, Sample DPH English 07/2023 PDF
F-02967 Statewide Trauma Advisory Council (STAC) Agenda Request DPH English 02/2022 HTML
F-02973 Statewide Trauma Advisory Council: Advisory Board Team Member Application DPH English 03/2025 Word
F-20935 Status Report to Court for Plan Compliance DCTS English 03/2017 PDF
F-01344 Strategies for Success with People Who Have Dementia-Behavior Analysis Worksheet-Model DPH English 09/2016 PDF

Glossary

 
Last revised December 4, 2024