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DHS-2977-ENG Important Notice and Parental Fee Worksheet
DHS-3203-ENG Referral for an MA Lien or Notice of Potential Claim
DHS-3767A-ENG Required Information from an Insurer for an MA Member's Cost-Effective Health Insurance Determination
DHS-3767B-ENG Prorating Premium Amounts to Decide Whether Health Insurance Is Cost Effective
DHS-3767C-ENG Cost-Effective-Insurance Calculation
DHS-3769A-ENG Legally Nonlicensed (LNL)Provider Training Documentation Form
DHS-3821-ENG Indian Child Welfare Act and Minnesota Indian Family Preservation Act Non-compliance Complaint Form
DHS-4015-ENG Waiver and Alternative Care (AC) Programs - Provider Enrollment Application
DHS-4044C-ENG State Vehicle Assignment
DHS-4839E-ENG Notice of Privacy Practices for all health care programs (except MFPP) (insert)
DHS-5107-ENG Administration of the Child Care Assistance Program - 2018-2019 County and Tribal Child Care Fund Plan
DHS-6633A-ENG CDCS Community Support Plan Addendum with 2017 Provider Rate Increase
DHS-6638-ENG Service Request Form for HCBS Waiver, Alternative Care (AC), Moving Home Minnesota or Essential Community Supports
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