DHS-1958-ENG Full Child Support (IV-D) Services Application and Information on Child Support

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

DHS-2825-ENG Notice of Contracted Per Diem Rates

DHS-3131-ENG Notice of Intentional Program Violation – Waiver of ADH

DHS-3767-ENG Request for Group Health Plan Information

DHS-3767A-ENG Request for Employee's Group Health Plan Information

DHS-3767B-ENG Request for Individual Health Plan Information

DHS-3767C-ENG Request for Policyholder's Insurance Information

DHS-3767E-ENG Your Health Insurance Is Cost Effective

DHS-3767F-ENG Your Health Insurance Is Not Cost Effective

DHS-3767G-ENG Application for a Good Cause Waiver

DHS-3767H-ENG Determination for a Good Cause Waiver

DHS-3821-ENG ICWA Noncompliance Complaint Form

DHS-4016-ENG MHCP Individual Practitioner - Provider Enrollment Application

DHS-4060-ENG Request to Close Support Case

DHS-4145-ENG County Notice of IMD Status

DHS-4469-ENG Individual Personal Care Assistant (PCA) Enrollment Application

DHS-4689A-ENG Screening Deletion Request

DHS-4813A-ENG Child and Teen Checkups 0 - 1 Month Well Visit

DHS-4813B-ENG Child and Teen Checkups 2-Month Well Visit

DHS-4813C-ENG Child and Teen Checkups 4-Month Well Visit

DHS-4813D-ENG Child and Teen Checkups 6-Month Well Visit

DHS-4813E-ENG Child and Teen Checkups 9-Month Well Visit

DHS-4813F-ENG Child and Teen Checkups 12-Month Well Visit

DHS-4813G-ENG Child and Teen Checkups 15-Month Well Visit

DHS-4813H-ENG Child and Teen Checkups 18-Month Well Visit

DHS-4813I-ENG Child and Teen Checkups 24-Month Well Visit

DHS-4813J-ENG Child and Teen Checkups 30-Month Well Visit

DHS-4813K-ENG Child and Teen Checkups - 3-year well child visit

DHS-4813L-ENG Child and Teen Checkups 4-Year Well Visit

DHS-4813M-ENG Child and Teen Checkups 5-Year Well Visit

DHS-4813N-ENG Child and Teen Checkups 6-Year Well Visit

DHS-4813O-ENG Child and Teen Checkups 7-Year Well Visit

DHS-4813P-ENG Child and Teen Checkups 8-Year Well Visit

DHS-4813Q-ENG Child and Teen Checkups 9-Year Well Visit

DHS-4813R-ENG Child and Teen Checkups 10-Year Well Visit

DHS-4813S-ENG Child and Teen Checkups 11-Year Well Visit

DHS-4813T-ENG Child and Teen Checkups 12-Year Well Visit

DHS-4813U-ENG Child and Teen Checkups 13 and 14-Year Well Visit

DHS-4813V-ENG Child and Teen Checkups 15-Year Well Visit

DHS-4813W-ENG Child and Teen Checkups 16-Year Well Visit

DHS-4813X-ENG Child and Teen Checkups 17-Year Well Visit

DHS-4813Y-ENG Child and Teen Checkups 18-Year Well Visit

DHS-4813Z-ENG Child and Teen Checkups 19 and 20-Year Well Visit

DHS-5274-ENG Minnesota Child Care Assistance Program Redetermination Form

DHS-5836-ENG Annual Review of Ward under Public Guardianship

DHS-5841-ENG Managed Care Organization, County Agency and Tribal Nation Communication Form - Recommendation for State Plan Home Care Services

DHS-6218-ENG Housing Access Coordination Exception Request for people with criminal, subpar credit or eviction history

DHS-6790G-ENG Rate Management Worksheet - Customized Living Services / 24 Hour Customized Living Services / Residential Care Services

DHS-6979-ENG MnCHOICES Help Desk Contact Form

DHS-7108-ENG CMDE Medical Necessity Summary Information

DHS-7108A-ENG EIDBI Comprehensive Multi-Disciplinary Evaluation (CMDE) Medical Necessity Summary Information Signature Form (Addendum A) 

DHS-7109-ENG Individual Treatment Plan (ITP) and Progress Monitoring

DHS-7109A-ENG EIDBI Individual Treatment Plan (ITP) and Progress Monitoring Signature Form (Addendum A)

DHS-7109B-ENG EIDBI: Additional Developmental Goal Domains Worksheet for ITP Form (Addendum B)

DHS-7414C-ENG Emergency Preparedness Plan - Family Child Care

DHS-7823-ENG Authorization to Obtain Financial Information from the Account Validation Service (AVS)

DHS-7883A-ENG You have been placed on the Child Care Assistance Program (CCAP) waiting list

DHS-7883B-ENG Child Care Assistance Program (CCAP) waiting list update

DHS-7883C-ENG Child Care Assistance Program (CCAP) funds available

DHS-7883D-ENG You will be removed from the Child Care Assistance Program (CCAP) waiting list

DHS-7934-ENG Family Child Care Child Enrollment Form

DHS-7952A-ENG Yearly In-Service Training Record - Licensed Child Care Centers

DHS-7953A-ENG Orientation Training Record - Licensed Child Care Centers

DHS-7954A-ENG Risk Reduction Plan

DHS-7964-ENG Variance request Extended Use of Substitute

DHS-7965-ENG Substitute Hours Tracking

DHS-7966-ENG Licensing Requirement Dispute