Forms published to eDocs (October 2018)

Minnesota Department of Human Services logo

Forms published to eDocs

October 2018


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-2818-ENG Authorization for Out-of-State Travel

DHS-3070-ENG Service Agreement

DHS-3459-ENG Individualized Education Program (IEP) Services Data Collection Form

DHS-3550-ENG Minnesota Child Care Assistance Program Application

DHS-4005-ENG TED Application

DHS-4676-ENG MHCP Inpatient Hospital Authorization Form

DHS-5748-ENG Community Mental Health Center Applicant Assurance Statement

DHS-6749A-ENG GA or MSA Notice of Drug Felon Match

DHS-6810F-ENG Positive Supports Functional Behavior Assessment Quality Checklist

DHS-6810G-ENG Positive Supports Transition Plan Quality Checklist

DHS-7414B-ENG Legal Nonlicensed (LNL) Child Care Emergency Plan

DHS-7679-ENG Appointment letter

DHS-7683-ENG Accreditation Fee Reimbursement Request

DHS-7697-ENG Psychiatric Residential Treatment Facility (PRTF) Pending Notice

DHS-7699-ENG Psychiatric Residential Treatment Facility (PRTF) Notice of Approval

DHS-7759A-ENG Disability services remote support exception form

DHS-7774-ENG Serious Injury Reporting Form - Family Child Care

DHS-7776-ENG Admission and Arrangements - Family Child Care

DHS-7779-ENG Preliminary Information Form - Family Child Care


The following form(s) were made obsolete:


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