Forms published to eDocs (June 2023)

Minnesota Department of Human Services logo

Forms published to eDocs

June 2023

eDocs logo

DHS-2146-ENG Authorization for Release of Employment Information

DHS-2981-ENG Medical Assistance Parental Fee Form

DHS-2981-SPA Medical Assistance Parental Fee Form

DHS-3418 - Minnesota Health Care Programs Renewal (HMNRUSSOMSPAVIE)

DHS-3730A-ENG Uniform Service Standards Personnel Record

DHS-4022-ENG Personal Care Provider Organization or Personal Care Assistant Choice Provider Enrollment Application

DHS-4145-ENG County Notice of IMD Status

DHS-4461A-ENG Nursing Facility (NF) Liability Summary

DHS-4719-ENG Guidelines for Developing Policies and Procedures for Licensed Child Care Center

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

DHS-5223F-ENG Supplemental Nutrition Assistance Program (SNAP) Application for Seniors (Individuals and couples age 60 and older) (HMN, RUSSOMSPAVIE)

DHS-5360-ENG Children's Mental Health Children's Intensive Behavioral Health Services: Certification Application

DHS-5360C-ENG Children's Mental Health Children's Intensive Behavioral Health Services: Notification of Change

DHS-5820-ENG Disability Waiver Rates System Exception Reques

DHS-6000-ENG Designation of Billing Person for Personal Care Assistance (PCA)

DHS-6021-ENG Request to Close or Develop New Corporate Foster Care (and Community Residential Settings)

DHS-6200-ENG MFIP/DWP Self-Employment Business Plan

DHS-6759H-ENG Moving Home Minnesota Communication Form

DHS-7118-ENG Universal Licensing Application

DHS-7683-ENG Accreditation Fee Reimbursement Request

DHS-7786-ENG Request for Fire Inspection or Reinspection

DHS-7948-ENG Housing Stabilization Services Eligibility Request

DHS-7999-ENG Staffing Patterns for Licensed Child Care Centers

DHS-8262 - Minnesota Health Care Programs Renewal for Families, Children and Adults (HMN, RUS, SOM, SPAVIE)

DHS-8372-ENG Correction Order

DHS-8373-ENG Child Care Center Medication Authorization

DHS-8414-ENG Field Trip Authorization for Licensed Child Care Centers

DHS-8445-ENG MHCP Asset Information

DHS-8448-ENG AMHI/CSP Budget Revision Request

DHS-8450-ENG Guardian/Conservator Maltreatment and Licensing Agency Checks


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