Forms published to eDocs (May 2019)

Minnesota Department of Human Services logo

Forms published to eDocs

May 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-2243-ENG MDHS Authorization for Release of Information About Assets

DHS-2243A-ENG MDHS General Authorization for Release of Information

DHS-3550-ENG Minnesota Child Care Assistance Program Application

DHS-3773-ENG CRF Checklist Screening Form

DHS-3773A-ENG CRF Education Screening Form

DHS-3773B-ENG CRF Vulnerability Assessment and Sexual Abusive Behavior Screen

DHS-3773C-ENG CRF Cultural Screening Form

DHS-3773D-ENG CRF gender specific screening form

DHS-4300-ENG Request for Worker's Compensation Information

DHS-4533-ENG Get Your Child Support Payments Faster, Safer, Easier

DHS-5052-ENG Individualized Education Program (IEP) Services Annual Data Report Form

DHS-5107-ENG Administration of the Child Care Assistance Program - 2020-2021 County and Tribal Child Care Fund Plan

DHS-5682B-ENG Supervisor Injury/Illness Investigation Form

DHS-5682C-ENG Supervisor Accident/Injury Review

DHS-6762D-ENG Minnesota Adult Protection SDM Initial Safety Assessment

DHS-6762E-ENG Minnesota Adult Protection SDM Intake Assessment and Response Priority

DHS-6762F-ENG Minnesota Adult Protection SDM Strengths AND Needs Assessment/Reassessment

DHS-6762G-ENG Minnesota Adult Protection Standardized EPS Assessment

DHS-6762H-ENG Minnesota Adult Protection Standardized Final Safety Assessment

DHS-7015-ENG Trade Secret/Confidential Data Notice – RFP

DHS-7016-ENG State of Minnesota Workforce Certificate Information

DHS-7017-ENG Certification Regarding Lobbying

DHS-7610-ENG Consent/authorization for Release of Information

DHS-7895-ENG Information Security Questions


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