Forms published to eDocs (July 2019) Minnesota Department of Human Services sent this bulletin at 08/01/2019 07:30 AM CDT Forms published to eDocs July 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-2977-ENG Important Notice and Parental Fee Worksheet DHS-3067-ENG DD Screening Document DHS-3525-ENG Minnesota Health Care Programs Application and Renewal Form Medical Assistance for Women with Breast or Cervical Cancer (MA-BC) DHS-3531-ENG Application for Medical Assistance for Long-Term-Care Services (MA-LTC) DHS-3806-ENG MHCP: Early Intensive Developmental and Behavioral Intervention (EIDBI) Authorization Request DHS-3869-ENG Durable Medical Equipment Prosthetics Orthotics and Supplies (DMEPOS) Surety Bond DHS-3876-ENG MHCP Application for Certain Populations DHS-4186-ENG Justification for Use of Personal Vehicle Versus Rental Vehicle DHS-4461-ENG Nursing Facility (NF) Communication Form DHS-5207-ENG County agency address and phone number list DHS-5259A-ENG Ownership and Control Interest Disclosure Requirement DHS-6021B-ENG DSD Corporate Adult Foster Care/Community Residential Setting (CRS) Setting Closure Proposal DHS-6025-ENG Collaborative Practice Dental Hygienist Assurance Statement DHS-6633-ENG CDCS Budget Exception Request Form DHS-6633C-ENG Instructions to complete the CDCS Budget Exception Request Form DHS-6696-ENG MNsure Application for Health Coverage and Help Paying Costs DHS-6791A-ENG MnCHOICES Community Support Plan Worksheet DHS-7641R-ENG Youth Exploitation or Trafficking Safety Plan DHS-7921-ENG Professional Development Plan DHS-7934-ENG Family Child Care Child Enrollment Form The following form(s) were made obsolete: DHS-3340E-ENG Asset Assessment Results for Current HCBS Waiver Enrollee DHS-3340F-ENG Asset Assessment Request for Information for Current HCBS Waiver Enrollee DHS-6021X-ENG DSD Corporate Adult Foster Care/Community Residential Setting (CRS) Setting Closure Proposal DHS-7604-ENG Substance Use Disorder Provider Capacity Grant Application If you have questions, contact the eDocs Helpdesk. In order to view PDF forms on eDocs, download the latest FREE version of Adobe Reader.