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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-01623 OARS - Residential Placement Reviews DCTS English 10/2016 Word No
F-01624 OARS Alternative to Revocation (ATR) Referral DCTS English 10/2016 Word No
F-01626 OARS Facility Checklist DCTS English 10/2016 Word No
F-01625 OARS Participant Discharge Summary DCTS English 10/2016 Word No
F-01627 OARS Provider Case Manager Checklist DCTS English 10/2016 Word No
F-01622 OARS Records Checklist DCTS English 10/2021 Word No
F-01619 OARS Welcome Letter DCTS English 02/2021 Word No
F-02460 OBVI Bold Lined Paper DPH English 11/2019 PDF No
F-00321 OBVI Initial Interview Assessment DPH English 07/2016 Word No
F-01642 OBVI Orientation and Mobility Screening DPH English 07/2016 Word No
F-00201 Occupant Protection Plan Checklist for Lead Abatement Activities DPH English 05/2022 PDF No
F-00201S Occupant Protection Plan Checklist for Lead-Based Paint Activities, Spanish DPH Spanish 05/2022 PDF No
F-02610B Occupant Worksheet - Lead-Safe Homes Program Application DPH English 03/2024 PDF No
F-45003 Occupational Exposure Record Per Monitoring Period DPH English 02/2020 PDF No
F-20224 Office for the Blind and Visually Impaired Assessment / Plan / Evaluation DPH English 07/2017 PDF No
F-02590 Ongoing Review of Nonresidential Group Supported Employment Site Surveys DMS English 01/2020 HTML No
F-01620 Opening Avenues to Reentry Success (OARS) Informed Consent for Mental Health Evaluation, Treatment and Community Reintegration Services DCTS English 09/2016 Word No
F-02835 Opening Avenues to Reentry Success (OARS2) Informed Consent for Mental Health Evaluation, Treatment, and Community Reintegration Services DCTS English 07/2021 Word No
F-01601F Opioid and Stimulant Unmet Needs SOR3 DCTS English 08/2023 Excel No
F-00169 Opting Out of Local Education Agency (LEA) and State Education Agency (SEA) Notification DMS English 07/2018 PDF No
F-00169S Opting Out of Local Education Agency (LEA) and State Education Agency (SEA) Notification, Spanish DMS Spanish 07/2018 PDF No
F-11103 Optional Outpatient Mental Health Assessment and Treatment / Recovery Plan DMS English 10/2008 Word No
F-11103 Optional Outpatient Mental Health Assessment and Treatment / Recovery Plan DMS English 10/2008 PDF No
F-11103A Optional Outpatient Mental Health Assessment and Treatment / Recovery Plan: Completion Instructions DMS English 07/2012 PDF No
F-01198 Optional School-Based Services Activity Log Nursing / Therapy Medical Services DMS English 07/2008 PDF No
F-01198 Optional School-Based Services Activity Log Nursing / Therapy Medical Services DMS English 07/2008 Word No
F-01199 Optional School-Based Services Activity Medication Administration DMS English 07/2008 Word No
F-01199 Optional School-Based Services Activity Medication Administration DMS English 07/2008 PDF No
F-02583 Options Counseling Record Review Tool DPH English 08/2021 Word No
F-02861 Options Counseling Supervisor Observation and Support Tool DPH English 08/2021 Word No
F-00780 Options Counseling Tip Card DPH English 02/2021 PDF No
F-00780A Options Counseling Tip Card Supplement DPH English 11/2018 PDF No
F-25207 Order Granting Capias DCTS English 03/2021 PDF No
F-25207 Order Granting Capias DCTS English 03/2021 Word No
F-25180 Order of Discharge Upon Expiration of Commitment DCTS English 03/2021 PDF No
F-25180 Order of Discharge Upon Expiration of Commitment DCTS English 03/2021 Word No
F-25205 Order to Transport DCTS English 10/2018 PDF No
F-25205 Order to Transport DCTS English 10/2018 Word No
F-00989N Other Services / Community and Medical Supports (IFSP) DMS English 02/2017 Word No
F-00989NS Other Services / Community and Medical Supports (IFSP), Spanish DMS Spanish 02/2017 Word No
F-80940A Out-of-State Travel Request DES English 06/2011 HTML No
F-00381 Outpatient Mental Health Clinic Certification Withdrawal Checklist DQA English 03/2011 Word No
F-00381 Outpatient Mental Health Clinic Certification Withdrawal Checklist DQA English 03/2011 PDF No
F-00785 Outpatient Mental Health Clinic Recertification Application - DHS 35 DQA English 08/2016 PDF No
F-00785 Outpatient Mental Health Clinic Recertification Application - DHS 35 DQA English 08/2016 Word No
F-00059 Outpatient Mental Health Clinics Initial Certification Application - DHS 35 DQA English 06/2024 Word No
F-02610 Owner-Occupied Properties - Lead-Safe Homes Program Application DPH English 03/2024 PDF No
F-02483 PACE Program Enrollment DPH English 02/2024 Word No
F-02483 PACE Program Enrollment (DocuSign) DPH English 02/2024 HTML No
F-02483LP PACE Program Enrollment (Large Print) DPH English 02/2024 Word No

Glossary

 
Last revised December 8, 2023