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DHS-0312A-ENG Adoption Placement Decision Summary for a Child Under Guardianship of the Commissioner
DHS-0666-ENG Compliance with SNAP, MFIP, DWP and ADH Decisions
DHS-2120-ENG Household Report Form
DHS-2883-ENG Request for verification of school attendance/progress
DHS-2961-ENG Notice of Requirement to Attend School
DHS-3067-ENG DD Screening Document
DHS-3166-ENG Employment Services Referral
DHS-3548-ENG Alternative Care Program Client Disclosure Form
DHS-3767D-ENG Determination of Cost Effectiveness
DHS-4005L-ENG Telephone Equipment Distribution Program Brochure and Application (large print)
DHS-4719A-ENG Guidelines for Developing Policies and Procedures for Licensed Child Care Centers
DHS-4740-ENG Minnesota Family Planning Program (MFPP) Application and Renewal Form
DHS-5223F-HMN Supplemental Nutrition Assistance Program (SNAP) Application for Seniors (Individuals and couples age 60 and older) - Hmong
DHS-5223F-RUS Supplemental Nutrition Assistance Program (SNAP) Application for Seniors (Individuals and couples age 60 and older) - Russian
DHS-5223F-SOM Supplemental Nutrition Assistance Program (SNAP) Application for Seniors (Individuals and couples age 60 and older) - Somali
DHS-5223F-SPA Supplemental Nutrition Assistance Program (SNAP) Application for Seniors (Individuals and couples age 60 and older) - Spanish
DHS-5223F-VIE Supplemental Nutrition Assistance Program (SNAP) Application for Seniors (Individuals and couples age 60 and older) - Vietnamese
DHS-5748-ENG Community Mental Health Center Assurance Statement
DHS-5915-ENG MHCP Returned Check
DHS-6037-ENG Aging & Disability Services: MnCHOICES Lead Agency Transfer and Communication Form
DHS-7097-ENG Office of Inspector General Employer Insurance Verification Form
DHS-7108-ENG CMDE Medical Necessity Summary Information
DHS-7108S-ENG CMDE Medical Necessity Summary Information Signature Page
DHS-7120B-ENG Early Intensive Developmental and Behavioral Intervention (EIDBI) Provider Agency Assurance Statement
DHS-7305-ENG Officer-Involved Community-Based Care Coordination Screening Tool
DHS-7306-ENG Recruitment and retention in supports for Minnesotans with disabilities: An assessment guide and toolkit
DHS-8168-ENG DSD Contact Form
DHS-8264B-ENG Opioid Prescribing Improvement Program: Measure 3 self-assessment
DHS-8341-ENG Emergency Escape Plan
DHS-8359-ENG Adult Foster Care and Community Residential Services Certification Licensing Checklist
DHS-8360-ENG Application Tracking Log
DHS-8362-ENG Complaint Log
DHS-8364-ENG Foster Care Drug and Alcohol Policy
DHS-8366-ENG Licensing Intake Complaint Form
DHS-8376-ENG SNAP Homeless Shelter Deduction Worksheet
DHS-8394-ENG Opioid Prescribing Improvement Program Quality Improvement Evaluation
Form(s) made obsolete:
DHS-3377-ENG Release of information
DHS-5316-ENG Targeted Review - Child Care Assistance - Income/Copayment
DHS-5440-ENG Minnesota Family Planning Program Renewal
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.
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