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DHS-2630-ENG Alternative Care Program Eligibility Worksheet for Unmarried Individuals or Married Couples When Both May Choose the Alternative Care Program or a Married Person Whose Spouse Is an EW Recipient or Is Living in a Nursing Facility
DHS-2630A-ENG Alternative Care Program Eligibility Worksheet for a Married Person who has a Community Spouse
DHS-3912-ENG Community-Based Services (CBS) Program Referral Form
DHS-3956-ENG Elderly Waiver Conversion Rate Request
DHS-4296-ENG General Consent/Authorization for Release of Information
DHS-4639-ENG Alternative Care Program Monthly Fee and Payment Information
DHS-5259-ENG Disclosure of Ownership and Control Interest of an Entity
DHS-5504B-ENG Exception Request for Environmental Accessibility Adaptations that Exceed $40,000 (CAC, CADI, BI and DD Waivers)
DHS-6021-ENG Request to Close or Develop New Corporate Foster Care (and Community Residential Settings)
DHS-6683-ENG Essential Community Supports Program (ECS) Financial Eligibility Worksheet for: Unmarried Individuals, Married couples when both are requesting ECS, Married Couples – spouse served under AC, EW or in a nursing home
DHS-6683A-ENG Essential Community Supports Program (ECS) Eligibility Worksheet for a Married Individual when only one spouse is requesting services
DHS-6791E-ENG MnCHOICES Reassessment Communication Form
DHS-6826-ENG Essential Community Supports (ECS) Financial Disclosure Form
DHS-6979-ENG MnCHOICES Help Desk Contact Form
DHS-7016-ENG State of Minnesota Workforce Certificate Information
DHS-7075-ENG State of Minnesota - Equal Pay Certificate
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
DHS-7181C-ENG Mental Health Adult Rehabilitative Mental Health Services (ARMHS) Branch Office Location Application
DHS-7610-ENG Consent/authorization for Release of Information
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