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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-01208B IRIS Fiscal Employer Agent (FEA) Quality Management Plan DMS English 01/2024 Excel No
F-01319 IRIS Involuntary Disenrollment Request DMS English 02/2017 Word No
F-02488 IRIS Monthly Rate of Service (MROS) Discrepancy Resolution DMS English 02/2022 Excel No
F-02470 IRIS Noncompliance Statement and Corrective Action Plan DMS English 03/2019 Word No
F-01206 IRIS One-Time Expense Request DMS English 02/2017 Word No
F-01206B IRIS One-Time Expense Request - Ramp DMS English 02/2017 Word No
F-01206A IRIS One-Time Expense Vendor Bid Comparison DMS English 02/2017 Word No
F-01947 IRIS Participant Education Manual: Acknowledgement DMS English 11/2018 Word No
F-01947FR IRIS Participant Education Manual: Acknowledgement, French DMS French 11/2018 Word No
F-01947LP IRIS Participant Education Manual: Acknowledgement, Large Print DMS English 11/2018 Word No
F-01205B IRIS Participant Education: Budget Amendments DMS English 03/2017 Word No
F-01205BAR IRIS Participant Education: Budget Amendments, Arabic DMS Arabic 03/2017 PDF No
F-10205BBU IRIS Participant Education: Budget Amendments, Burmese DMS English 03/2017 Word No
F-01205BFR IRIS Participant Education: Budget Amendments, French DMS French 03/2017 Word No
F-01205BH IRIS Participant Education: Budget Amendments, Hmong DMS Hmong 03/2017 Word No
F-01205BKA IRIS Participant Education: Budget Amendments, Karen DMS Karen 03/2017 PDF No
F-01205BKR IRIS Participant Education: Budget Amendments, Korean DMS Korean 03/2017 PDF No
F-01205BR IRIS Participant Education: Budget Amendments, Russian DMS Russian 03/2017 Word No
F-01205BS IRIS Participant Education: Budget Amendments, Spanish DMS Spanish 03/2017 Word No
F-01205C IRIS Participant Education: One-Time Expense Requests DMS English 11/2019 Word No
F-01205CAR IRIS Participant Education: One-Time Expense Requests, Arabic DMS Arabic 11/2019 PDF No
F-01205CH IRIS Participant Education: One-Time Expense Requests, Hmong DMS Hmong 11/2019 Word No
F-01205CKA IRIS Participant Education: One-Time Expense Requests, Karen DMS Karen 11/2019 PDF No
F-01205CKR IRIS Participant Education: One-Time Expense Requests, Korean DMS Korean 11/2019 PDF No
F-01205CR IRIS Participant Education: One-Time Expense Requests, Russian DMS Russian 11/2019 Word No
F-01205CS IRIS Participant Education: One-Time Expense Requests, Spanish DMS Spanish 11/2019 Word No
F-01205J IRIS Participant Education: Self-Directed Personal Care DMS English 02/2017 Word No
F-01205JAR IRIS Participant Education: Self-Directed Personal Care, Arabic DMS Arabic 02/2017 PDF No
F-01205JH IRIS Participant Education: Self-Directed Personal Care, Hmong DMS Hmong 02/2017 Word No
F-01205JKA IRIS Participant Education: Self-Directed Personal Care, Karen DMS Karen 02/2017 PDF No
F-01205JKR IRIS Participant Education: Self-Directed Personal Care, Korean DMS Korean 02/2017 PDF No
F-01205JR IRIS Participant Education: Self-Directed Personal Care, Russian DMS Russian 02/2017 Word No
F-01205JS IRIS Participant Education: Self-Directed Personal Care, Spanish DMS Spanish 02/2017 Word No
F-01201C IRIS Participant Employer / Participant - Hired Worker Agreement DMS English 02/2017 Word No
F-01201CH IRIS Participant Employer / Participant - Hired Worker Agreement, Hmong DMS Hmong 02/2017 Word No
F-01201CR IRIS Participant Employer / Participant - Hired Worker Agreement, Russian DMS Russian 02/2017 Word No
F-01201CS IRIS Participant Employer / Participant - Hired Worker Agreement, Spanish DMS Spanish 02/2017 Word No
F-01201A IRIS Participant-Hired Worker Relationship Identification DMS English 03/2023 Word No
F-01201AH IRIS Participant-Hired Worker Relationship Identification, Hmong DMS Hmong 03/2023 Word No
F-01201AR IRIS Participant-Hired Worker Relationship Identification, Russian DMS Russian 03/2023 Word No
F-01201AS IRIS Participant-Hired Worker Relationship Identification, Spanish DMS Spanish 03/2023 Word No
F-01201 IRIS Participant-Hired Worker Set-Up DMS English 09/2020 Word No
F-01201H IRIS Participant-Hired Worker Set-Up, Hmong DMS Hmong 09/2020 Word No
F-01201R IRIS Participant-Hired Worker Set-Up, Russian DMS Russian 09/2020 Word No
F-01201S IRIS Participant-Hired Worker Set-Up, Spanish DMS Spanish 09/2020 Word No
F-02833 IRIS Performance Improvement Project Annual Report DMS English 07/2021 PowerPoint No
F-01310A IRIS Program Conflict of Interest Disclosure - Participant DMS English 02/2017 Word No
F-01310 IRIS Program Conflict of Interest Disclosure - Provider DMS English 02/2017 Word No
F-01200 IRIS Program Cost Share Repayment Agreement DMS English 02/2017 Word No
F-01314 IRIS Program Employment Checklist DMS English 02/2017 Word No

Glossary

 
Last revised December 8, 2023