Forms published to eDocs (September 2020)

Minnesota Department of Human Services sent this bulletin at 10/01/2020 08:00 AM CDT
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Forms published to eDocs

September 2020
eDocs

 

DHS-2414-ENG Notice of Late or Incomplete Household Report Form, Health Care Renewal Form or Combined Six-Month Report

DHS-3427-ENG LTC Screening Document - AC, BI, CAC, CADI, ECS, EW, MHM, MSC+, MSHO

DHS-3754-ENG DSD Resource Center Portal

DHS-4145-ENG County Notice of IMD Status

DHS-5223C-ENG Combined Application - Addendum (For SNAP (food) and cash assistance programs)

DHS-5716-ENG MHCP Individual DSW Information Change Form

DHS-6189H-ENG Family Caregiver Services Provider Assurance Statement

DHS-6189K-ENG Homemaker Provider Assurance Statement

DHS-6855-ENG Designation of Billing Person for Home and Community-Based Services Waiver or Alternative Care

DHS-7120C-ENG EIDBI Assurance Statement for Qualified Supervising Professionals (QSP)

DHS-7305-ENG Officer-Involved Care Coordination Services Screening Tool

DHS-7307-ENG Housing Focused Person-Centered Plan

DHS-7310-ENG Application for MA Coverage for COVID-19 Testing

DHS-7968-ENG Housing Consultation Providers Applicant Assurance Statement

DHS-7982-ENG Notice to parents considering voluntary placement of their child co-located with them in a residential substance use disorder treatment program

 

The following form(s) were made obsolete:

None

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