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DHS-0852-ENG MN Merit System – Report of Personnel Action
DHS-0857-ENG MN Merit System – Probationary Evaluation
DHS-0858-ENG MN Merit System – Separation Rating
DHS-0876-ENG MN Merit System – Position Description
DHS-1609-ENG Nonreceipt/Replacement Request
DHS-2630-ENG Alternative Care Program Eligibility Worksheet
DHS-2630A-ENG Alternative Care Program Eligibility Worksheet Type A
DHS-3141-ENG Variance Request
DHS-3535-ENG MHCP Individual Provider Profile Change
DHS-3725-ENG EFT Supplier ID Notification
DHS-3751-ENG Individual Community Living Support (ICLS) - Planning Form
DHS-3891A-ENG Request for Early Intensive Developmental and Behavioral Intervention (EIDBI) NETStudy 2.0 Agency ID Number
DHS-4015-ENG Home and Community Based Services (HCBS) – Provider Enrollment Application
DHS-4258B-ENG Minnesota Adoption and Foster Care Individual Fact Sheet
DHS-5181-ENG LTC: Communication of long-term supports and services eligibility form
DHS-5223D-ENG Combined Application - Child Care Addendum
DHS-5274-ENG Minnesota Child Care Assistance Program Redetermination Form
DHS-5820C-ENG Lead agency provider tool for DWRS exceptions (residential)
DHS-5820D-ENG Lead agency provider tool for DWRS exceptions (day or unit)
DHS-5820E-ENG Lead Agency Provider Tool for DWRS Exceptions (Customized Living)
DHS-6683-ENG Essential Community Supports Program (ECS) Eligibility Worksheet
DHS-6683A-ENG Essential Community Supports Program (ECS) Eligibility Worksheet Type A
DHS-6759H-ENG Moving Home Minnesota Communication Form
DHS-7118-ENG Universal Licensing Application
DHS-7120A-ENG Early Intensive Developmental and Behavioral Intervention (EIDBI) Comprehensive Multi-Disciplinary Evaluation (CMDE) Provider Assurance Statement
DHS-7120D-ENG Early Intensive Developmental and Behavioral Intervention (EIDBI) Level I Provider Assurance Statement
DHS-7120E-ENG Early Intensive Developmental and Behavioral Intervention (EIDBI) Level II Provider Assurance Statement
DHS-7120F-ENG Early Intensive Developmental and Behavioral Intervention (EIDBI) Level III Provider Assurance Statement
DHS-7190B-ENG PCA/CFSS Cost Reporting Time Study Worksheet
DHS-7197-ENG Child Care Assistance Program Case Review – Corrective Action Form
DHS-7219-ENG Optional Form for Parent Statement: Infant Less Than Six Months of Age Regularly Rolling Over
DHS-7645B-ENG EIDBI Benefit: Provider agency rights and responsibilities (CMN | HMN | KAR | ORM | RUS | SOM | SPA | VIE)
DHS-7683-ENG Accreditation Fee Reimbursement Request
DHS-8059-ENG Waiver Services Remote Support Provider Assurance Statement
DHS-8070L-ENG Great Start Compensation Support Payment Program: Legal Nonlicensed One-Time Payment Application
DHS-8159 Supplemental Nutrition Assistance Program (SNAP) Work Rules Notice (HMN | RUS | SOM | SPA | VIE)
DHS-8313-ENG Child Foster Care Home Safety Checklist
DHS-8529-ENG Cradleboard Variance Request Form
DHS-8531-ENG Helmet Approval for Sleeping Infant
DHS-8536-ENG Parent Cradleboard Request and Monthly Cradleboard Check Form
Form(s) made obsolete:
DHS-3956A-ENG - Elderly Waiver CDCS Conversion Rate Request
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