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Data Collection (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 form, enter the number or a portion of the title in the search box below.

Assigned Number Title Division Language Release Date File Type Available to Order
F-24277NE Informed Consent For Medication-Namenda DCTS English 04/2021 PDF No
F-24277NB Informed Consent For Medication-Navane DCTS English 08/2020 PDF No
F-24277NB Informed Consent For Medication-Navane DCTS English 08/2020 Word No
F-24277NG Informed Consent For Medication-Nuedexta DCTS English 03/2017 Word No
F-24277NG Informed Consent For Medication-Nuedexta (PDF, 34 KB) DCTS English 03/2017 PDF No
F-24277NF Informed Consent For Medication-Nuplazid DCTS English 05/2020 PDF No
F-24277NF Informed Consent For Medication-Nuplazid DCTS English 05/2020 Word No
F-24277PB Informed Consent For Medication-Paxil DCTS English 08/2020 PDF No
F-24277PB Informed Consent For Medication-Paxil DCTS English 08/2020 Word No
F-24277PE Informed Consent For Medication-Prozac DCTS English 06/2020 PDF No
F-24277R Informed Consent For Medication-Remeron DCTS English 08/2020 Word No
F-24277R Informed Consent For Medication-Remeron DCTS English 08/2020 PDF No
F-24277RB Informed Consent For Medication-Restoril DCTS English 11/2017 PDF No
F-24277RB Informed Consent For Medication-Restoril DCTS English 11/2017 Word No
F-24277RD Informed Consent For Medication-Risperdal DCTS English 04/2021 PDF No
F-24277RD Informed Consent For Medication-Risperdal DCTS English 04/2021 Word No
F-24277RE Informed Consent For Medication-Ritalin DCTS English 05/2021 PDF No
F-24277RE Informed Consent For Medication-Ritalin DCTS English 05/2021 Word No
F-24277RF Informed Consent For Medication-Rozerem DCTS English 08/2020 Word No
F-24277RF Informed Consent For Medication-Rozerem DCTS English 08/2020 PDF No
F-24277S Informed Consent For Medication-Serax DCTS English 11/2017 PDF No
F-24277S Informed Consent For Medication-Serax DCTS English 11/2017 Word No
F-24277SD Informed Consent For Medication-Serzone DCTS English 08/2020 PDF No
F-24277SD Informed Consent For Medication-Serzone DCTS English 08/2020 Word No
F-24277SI Informed Consent For Medication-Symbyax DCTS English 08/2020 Word No
F-24277SI Informed Consent For Medication-Symbyax DCTS English 08/2020 PDF No
F-24277TH Informed Consent For Medication-Topamax DCTS English 05/2021 Word No
F-24277TH Informed Consent For Medication-Topamax DCTS English 05/2021 PDF No
F-24277TE Informed Consent For Medication-Tranxene DCTS English 11/2017 PDF No
F-24277TE Informed Consent For Medication-Tranxene DCTS English 11/2017 Word No
F-24277TF Informed Consent For Medication-Trilafon DCTS English 08/2020 Word No
F-24277TF Informed Consent For Medication-Trilafon DCTS English 08/2020 PDF No
F-24277VI Informed Consent For Medication-Viibryd DCTS English 08/2017 Word No
F-24277VI Informed Consent For Medication-Viibryd DCTS English 08/2017 PDF No
F-24277VE Informed Consent For Medication-Vyvanse DCTS English 05/2021 PDF No
F-24277VE Informed Consent For Medication-Vyvanse DCTS English 05/2021 Word No
F-20941 Informed Consent for Participation in Wisconsin's Money Follows the Person (MFP) Demonstration DMS English 09/2018 Word No
F-20941S Informed Consent for Participation in Wisconsin's Money Follows the Person (MFP) Demonstration, Spanish DMS Spanish 09/2018 Word No
F-24277 Informed Consent for Psychotropic Medication DCTS English 12/2016 HTML No
F-21076 Informed Consent – Children's Long-Term Support Functional Screen DMS English 03/2021 Word No
F-21076KA Informed Consent – Children's Long-Term Support Functional Screen, Karen DMS Karen 03/2021 PDF No
F-21076RY Informed Consent – Children's Long-Term Support Functional Screen, Rohingya DMS Rohingya 03/2021 Word No
F-21076SO Informed Consent – Children's Long-Term Support Functional Screen, Somali DMS Somali 03/2021 Word No
F-02031S Initial Application - Individual Lead Disciplines, Spanish DPH Spanish 11/2023 PDF No
F-03082C Initial Certification Application for Branch Office or School Branch Office DQA English 08/2022 Word No
F-03082F Initial Certification Application for DHS 75.59 Opioid Treatment Program (OTP) Mobile Unit DQA English 07/2023 Word No
F-03082 Initial Certification or Change of Ownership Application for DHS 75.14 and DHS 75.15 Service Certification DQA English 08/2022 Word No
F-03082A Initial Certification or Change of Ownership Application for DHS 75.49, DHS 75.50, DHS 75.51, and DHS 75.52 Service Certification DQA English 08/2022 Word No
F-03082E Initial Certification or Change of Ownership Application for DHS 75.53-DHS 75.58 Service Certification DQA English 09/2022 Word No
F-03082B Initial Certification or Change of Ownership Application for DHS 75.59 Service Certification DQA English 08/2022 Word No
Last revised December 8, 2023