 DHS-2128-ENG Minnesota Health Care Programs Renewal for People Receiving Medical Assistance for Long-Term Care Services (MA-LTC)
DHS-3308A-ENG Minnesota Health Care Programs Memo Template
DHS-3403-ENG Minnesota Health Care Programs Fee-for-Service Coverage
DHS-3418-ENG Minnesota Health Care Programs Renewal
DHS-3891-ENG Request for Licensing Agency ID Numbe
DHS-4138-ENG Fee-for-Service (FFS) only or FFS and Managed Care Organization In-Network Provider Agreement
DHS-4839L-ENG Notice of Privacy Practices and Rights and Responsibilities for Combined Forms
DHS-5032-ENG Moving Home Minnesota Intake Form
DHS-5207-ENG County agency address and phone number list
DHS-6000-ENG Designation of Billing Person for Personal Care Assistance (PCA)
DHS-6759H-ENG Moving Home Minnesota Communication Form
DHS-6893S-ENG CFSS: Consultation Services Session Documentation Form (draft for public comment)
DHS-6893T-ENG CFSS: Worker Information for CFSS budget model (draft for public comment)
DHS-7759B-ENG Customized Living Size-Limit Exception Request Form
DHS-7823-ENG Authorization to Obtain Financial Information from the Asset Verification Service (AVS)
DHS-7867-ENG Child Care Assistance Program Legal Nonlicensed Provider Monitoring Checklist
DHS-7995-ENG Individual Child Care Program Plan - For Licensed Child Care Centers
DHS-8368-ENG Necessity of Care Recommendation/Referral Checklist
Form(s) made obsolete:
None
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