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Please note that the following forms may have new web addresses. Web pages or other documents that link to these forms may need to be updated.
 DHS-2243-ENG
MDHS Authorization for Release of Information About Assets
DHS-2338-ENG
Cooperation with Child Support Enforcement
DHS-3459-ENG
IEP Services Data Collection Form
DHS-3628-ENG
Notice of Denial of Child Support Good Cause Exemption
DHS-4022-ENG
Minnesota Health Care Programs Personal Care Providers Application
DHS-5148-ENG Behavior Intervention Reporting Form
DHS-5223-ENG
MDHS Combined Application Form
DHS-5367-ENG
Minnesota Child Care Assistance Programs - Parent Acknowledgement When Choosing a Legal Nonlicensed Provider
DHS-5576-ENG
Combined Six-Month Report
DHS-5675-ENG
Electronic Claims Payment Affidavit
DHS-6381-ENG
CCDTF Residential and Inpatient Assurance Statement
DHS-6382-ENG
CCDTF Outpatient Services Assurance Statement
DHS-6451A-ENG
Special Needs BasicCare (SNBC) Letter and Choice Form
DHS-6939-ENG
MA-EPD Good Cause Application
DHS-7108-ENG
CMDE Medical Necessity Summary Information
DHS-7109-ENG
Individual Treatment Plan (ITP) and Progress Monitoring
DHS-7181-ENG
Mental Health Adult Rehabilitative Mental Health Services (ARMHS) Provider Application
DHS-7181A-ENG
Mental Health Adult Rehabilitative Mental Health Services (ARMHS) Provider Certification Requirements
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