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DHS-1795-ENG SSI Interim Assistance Authorization
DHS-1795A-ENG Interim Assistance Agreement
DHS-2114-ENG Request for Medical Opinion
DHS-2919-ENG Verification Request Form
DHS-2919-HMN Verification Request Form - Hmong
DHS-2919-RUS Verification Request Form - Russian
DHS-2919-SOM Verification Request Form - Somali
DHS-2919-SPA Verification Request Form - Spanish
DHS-2919-VIE Verification Request Form - Vietnamese
DHS-3610-ENG Children's Therapeutic Services and Supports (CTSS) Primary Certification Application
DHS-4795-ENG Minnesota Child Care Assistance Programs Quality Differential Rate Request Form
DHS-5192-ENG Minnesota Child Care Assistance Programs Legal Nonlicensed Provider Registration and Acknowledgment
DHS-5312D-ENG Child Care Assistance Program - Family Review Form
DHS-5312E-ENG Child Care Assistance Program - Provider Review Form
DHS-5880-ENG MHCP Cost of Care for Tuberculosis
DHS-6020-ENG Supplemental Nutrition Assistance Program (SNAP) Employment and Training Plan
DHS-6790M-ENG RMS Worksheet – Day and Employment Services
DHS-7307-ENG Housing Focused Person-Centered Plan
DHS-7310-HMN Application for MA Coverage for COVID-19 Testing - Hmong
DHS-7310-RUS Application for MA Coverage for COVID-19 Testing - Russian
DHS-7310-SOM Application for MA Coverage for COVID-19 Testing - Somali
DHS-7310-SPA Application for MA Coverage for COVID-19 Testing - Spanish
DHS-7310-VIE Application for MA Coverage for COVID-19 Testing - Vietnamese
DHS-7953A-ENG Orientation Training Record Licensed Child Care Centers
DHS-8059-ENG Waiver Services Remote Support Provider Assurance Statement
DHS-8097-ENG Qualified residential treatment program (QRTP) Assessment and Recommendation Form
DHS-8225-ENG Rate Exception Request: Fee-for-Service Subcontracted Targeted Case Management
The following form(s) were made obsolete:
DHS-3337-ENG - MFIP Self-Employment Income Worksheet
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