Forms published to eDocs (April 2021) Minnesota Department of Human Services sent this bulletin at 04/30/2021 02:37 PM CDT Forms published to eDocs April 2021 DHS-2825-ENG Notice of Contracted Per Diem Rates DHS-3427-ENG LTC Screening Document - AC, BI, CAC, CADI, ECS, EW, MHM, MSC+, MSHO DHS-3428-ENG Minnesota Long Term Care Consultation Services Assessment Form DHS-3428A-ENG Minnesota Long Term Care Consultation Services Assessment Form: SW Section DHS-3751-ENG Individual Community Living Support (ICLS) - Planning Form DHS-3907-ENG MHCP Information Needed for Reported Change(s) DHS-4381-ENG DCT Incident Report DHS-5032-ENG Moving Home Minnesota Intake Form DHS-6217B-ENG Child Care Assistance Notice of Decision - Service Authorization for providers DHS-6791B-ENG MnCHOICES Community Support Plan with Coordinated Services and Supports Form DHS-6810-ENG Positive Support Transition Plan DHS-6873-ENG Authorization for Release of Information for the Successful Life Project DHS-6979-ENG MnCHOICES Help Desk Contact Form DHS-7020-ENG Responder Information/Declarations Form – Grant RFP DHS-7097-ENG Office of Inspector General Employer Insurance Verification Form DHS-7120C-ENG EIDBI Assurance Statement for Qualified Supervising Professionals (QSP) DHS-7122-ENG Professional Statement of Need DHS-7325-ENG 1115 Substance Use Disorder Reform Enrollment Checklist DHS-7883-ENG Child Care Assistance Program (CCAP) Basic Sliding Fee (BSF) waiting list screening DHS-8087-ENG Deaf and Hard of Hearing Services Division Terms of Service and Notice of Privacy Practices DHS-8089-ENG Deaf and Hard of Hearing Services Division Agreement for Mental Health Services DHS-8107-ENG Household Update Form DHS-8110-ENG Notice of Choice to End Housing Stabilization Services DHS-8117-ENG Terms and Conditions of iPhone/iPad Pilot DHS-8121-ENG Day Training and Habilitation (ICF/DD) Provider Enrollment Application The following form(s) were made obsolete: None 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. If you have questions, contact the eDocs Helpdesk. In order to view PDF forms on eDocs, download the latest FREE version of Adobe Reader.