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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-2925-ENG Long Term Consultation Community Support Plan
DHS-3159L-ENG Minnesota Voluntary Recognition of Parentage
DHS-3271-ENG Minnesota Health Care Programs Request for Information
DHS-3427-ENG LTC Screening Document - AC, BI, CAC, CADI, ECS, EW, MHM, MSC+, MSHO, SNBC
DHS-3428-ENG Minnesota Long Term Care Consultation Services Assessment Form
DHS-3428A-ENG Minnesota Long Term Care Consultation Services Assessment Form: SW Section
DHS-3907-ENG MHCP Information Needed for Reported Change(s)
DHS-3956-ENG Elderly Waiver Conversion Rate Request
DHS-4159A-ENG Adult Mental Health Rehabilitative Services Authorization Form
DHS-4427B-ENG Notice to Parent Considering Voluntary Placement of an Indian Child
DHS-4621-ENG MHCP Medical Support Referral
DHS-4695-ENG MHCP Authorization Form
DHS-5716-ENG MHCP Individual PCA Information Change Form
DHS-6189K-ENG Homemaker Providers Applicant Assurance Statement
DHS-6428-ENG MHCP Synagis Authorization Form
DHS-6638-ENG Service Request Form for HCBS Waiver, Alternative Care (AC), Moving Home Minnesota or Essential Community Supports
DHS-6740-ENG MNsure Small Business Health Options Program (SHOP) Health Coverage Application for Employers
DHS-6740A-ENG MNsure Small Business Health Options Program (SHOP) Health Coverage Application for Employees
DHS-6790C-ENG RMS Worksheets - Foster Care/SLS Corporate Daily
DHS-7120D-ENG EIDBI Assurance Statement for Level I Providers
DHS-7120E-ENG EIDBI Assurance Statement for Level II Providers
DHS-7120F-ENG EIDBI Assurance Statement for Level III Providers (Behavioral Support Specialists)
DHS-7279-ENG Olmstead Employment Practice Review Panel Story Template
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