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DHS-3067-ENG DD Screening Document
DHS-3427H-ENG Health Risk Assessment Screening Document - MSC+, MSHO and 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-3428H-ENG Minnesota Health Risk Assessment Form
DHS-3641-ENG Advance Recipient Notice of Non-covered Prescription
DHS-3956-ENG Elderly Waiver Conversion Rate Request
DHS-4005-ENG TED Application
DHS-4138-ENG Minnesota Department of Human Services Provider Agreement
DHS-4296-ENG General Consent/Authorization for Release of Information
DHS-4469A-ENG Individual Support Worker Enrollment Application (CDCS and CSG)
DHS-4794-ENG CCAP Change Report Form
DHS-4801-ENG Referral for an Alternative Care Estate Claim
DHS-5085A-ENG Individualized Education Plan (IEP) and Individualized Family Service Plan (IFSP) Evaluation Documentation Log
DHS-5191-ENG Minnesota Child Care Assistance Programs License Exempt Provider Registration and Acknowledgment
DHS-5223D-ENG Combined Application - Child Care Addendum
DHS-5318-ENG Minnesota Child Care Assistance Program Financial Tracking Form
DHS-6109-ENG Clinic Tool for the Assessment and Management of Persistent Pain
DHS-6633A-ENG CDCS Community Support Plan Addendum with 2018 EW and AC Rate Increase
DHS-6638-ENG HCBS Programs Service Request Form
DHS-6791D-ENG MnCHOICES Coordinated Services and Supports Plan Signature Sheet
DHS-6925-ENG Financial Management Services Provider Enrollment Application
DHS-7072-ENG MHCP High Dose Opioid Drug Prior Authorization
DHS-7618-ENG Home and Community-Based Settings Applicant Assurance Statement
DHS-7645A-ENG EIDBI Benefit: Your rights and responsibilities
DHS-7645B-ENG EIDBI Benefit: Provider agency rights and responsibilities
DHS-7694-ENG Psychiatric Residential Treatment Facility (PRTF) Notice of Denial
DHS-7750-ENG Application for Supplemental Security Income (SSI)/Social Security Disability Income (SSDI) Outreach, Access, and Recovery (SOAR) Pay-For-Performance and One-Time Service Funding Grants 2019-2020
DHS-7766-ENG Personnel Information Form (PIF)
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