Forms published to eDocs (August 2022)

Minnesota Department of Human Services logo

Forms published to eDocs

August 2022

eDocs

 

DHS-0033-HMN Appeal to State Agency - Hmong

DHS-0033-RUS Appeal to State Agency - Russian

DHS-0033-SOM Appeal to State Agency - Somali

DHS-0033-SPA Appeal to State Agency - Spanish

DHS-0033-VIE Appeal to State Agency - Vietnamese

DHS-2952-ENG Authorization for Release of Information About Residence and Shelter Expenses

DHS-3550-HMN Minnesota Child Care Assistance Program Application - Hmong

DHS-3550-RUS Minnesota Child Care Assistance Program Application - Russian

DHS-3550-SOM Minnesota Child Care Assistance Program Application - Somali

DHS-3550-SPA Minnesota Child Care Assistance Program Application - Spanish

DHS-3550-VIE Minnesota Child Care Assistance Program Application - Vietnamese

DHS-3909-ENG Proposal to Conduct Research on DHS Program Participants – Application for IRB Review

DHS-3909A-ENG Institutional Review Board (IRB) Academic Endorsement Form

DHS-3936-ENG My Move Plan Summary

DHS-3956-ENG Elderly Waiver Conversion Rate Request

DHS-4797-HMN Notification of Eligibility for Behavioral Health Home (BHH) Services - Hmong

DHS-4797-RUS Notification of Eligibility for Behavioral Health Home (BHH) Services - Russian

DHS-4797-SOM Notification of Eligibility for Behavioral Health Home (BHH) Services - Somali 

DHS-4797-SPA Notification of Eligibility for Behavioral Health Home (BHH) Services - Spanish

DHS-4797-VIE Notification of Eligibility for Behavioral Health Home (BHH) Services - Vietnamese

DHS-4797-VIE Notification of Eligibility for Behavioral Health Home (BHH) Services - Vietnamese

DHS-4797B-RUS Behavioral Health Home (BHH) Services Rights, Responsibilities and Consent - Russian

DHS-4797B-SOM Behavioral Health Home (BHH) Services Rights, Responsibilities and Consent - Somali 

DHS-4797B-SPA Behavioral Health Home (BHH) Services Rights, Responsibilities and Consent - Spanish

DHS-4797B-VIE Behavioral Health Home (BHH) Services Rights, Responsibilities and Consent - Vietnamese

DHS-5820E-ENG Lead Agency Provider Tool for DWRS Exceptions (Customized Living)

DHS-6790G-ENG Rate Management Worksheet - Customized Living Services and 24-Hour Customized Living Services

DHS-6790I-ENG Instructions to complete the Customized Living Rate Worksheet (DHS-6790G)

DHS-6887-ENG ASL Interpreter Website Consent Form

DHS-7118-ENG Universal Licensing Application

DHS-7356A-ENG Child Care Assistance Program Accuracy Review Income

DHS-7773-ENG Family Child Care Travel and Activity Authorization

DHS-8062-ENG Setting Capacity Report

DHS-8289-ENG Foster Care Dual License Variance Request

 

Form(s) made obsolete:

None


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