Forms published to eDocs (January 2019) Minnesota Department of Human Services sent this bulletin at 02/01/2019 07:00 AM CST Forms published to eDocs January 2019 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-0029E-ENG Medical Assistance With a Spenddown for Families With Children DHS-3165A-ENG Supplemental Nutrition Assistance Program Employment and Training (SNAP E&T) Status Update Form DHS-3610-ENG Children's Therapeutic Services and Supports (CTSS) Primary Certification Application DHS-3610A-ENG Children's Therapeutic Services and Supports (CTSS) Provider Assurance Statements DHS-3807A-ENG EIDBI Treatment Modality Submission Form DHS-4106C-ENG Health plan enrollment form for people 65 years old or older DHS-4695-ENG MHCP Authorization Form DHS-4759-ENG Special Needs or Pooled Trust Referral DHS-5036-ENG Annuity Designation for MA-LTC Applicants DHS-5037-ENG Notice of Obligation to Issuer of an Annuity DHS-5682B-ENG Supervisor Injury/Illness Investigation Form DHS-5682C-ENG Supervisor Accident/Injury Review DHS-6020-ENG SNAP Employment and Training Plan DHS-6124-ENG SMRT Authorization to Release Protected Health Information DHS-6633B-ENG CDCS Enhanced Budget Request and Community Support Plan Addendum DHS-6759H-ENG Moving Home Minnesota Communication Form DHS-6810F-ENG Functional Behavior Assessment Quality Checklist DHS-7020-ENG Responder Information/Declarations Form – Grant RFP DHS-7109-ENG Individual Treatment Plan (ITP) and Progress Monitoring DHS-7683-ENG Accreditation Fee Reimbursement Request DHS-7840-ENG Notice of Intent to bill for Individual Education Plan (IEP) Mental Health Evaluations The following form(s) were made obsolete: DHS-5193-ENG CCAP Authorization for Release of Background Study If you have questions, contact the eDocs Helpdesk. In order to view PDF forms on eDocs, download the latest FREE version of Adobe Reader.