 DHS-3159C-ENG Minnesota Voluntary Recognition of Parentage Spouse's Non-Parentage Statement
DHS-3159E-ENG Minnesota's Spouse's Non-parentage Statement Revocation Form (HMN | SOM | SPA)
DHS-3539-ENG Ryan White Program Application
DHS-3539B-ENG Ryan White New Applicant Form
DHS-3539F-ENG Ryan White Information Change Form
DHS-3539Z-ENG Ryan White Program Application – Attachments
DHS-3767D-ENG Determination of Cost Effectiveness
DHS-4005 - Minnesota Access to Communication Technology Application (HMN | RUS | SOM | SPA | VIE)
DHS-4016A-ENG Organization - Provider Enrollment Application
DHS-4074A-ENG Personal Care Assistance (PCA) Technical Change Request
DHS-4106A-ENG Health plan enrollment form
DHS-4292-ENG PCA Request Form
DHS-5576-ENG Combined Six-Month Report
DHS-6893A-ENG Community First Services and Supports (CFSS) Assessment
DHS-6893I-ENG Community First Services and Supports (CFSS) Request Form
DHS-6893K-ENG Community First Services and Supports (CFSS) Technical Change Request
DHS-7117 - MHCP Yearly Income Statement (HMN | ORM | RUS | SOM | SPA | VIE)
DHS-7323-ENG American Society of Addiction Medicine (ASAM) Level of Care Assurance Statement
DHS-7641Q-ENG Missing Episode Debriefing
DHS-8058-ENG Deaf, DeafBlind and Hard of Hearing State Services Division Consent to Telehealth Services
DHS-8058L-ENG Deaf, DeafBlind and Hard of Hearing State Services Division Consent to Telehealth Services (large print)
DHS-8086-ENG Mental Health Program Release of Information Consent
DHS-8087-ENG Deaf, DeafBlind and Hard of Hearing State Services Division Terms of Service and Notice of Privacy Practices
DHS-8087L-ENG Deaf, DeafBlind and Hard of Hearing State Services Division Terms of Service and Notice of Privacy Practices (large print)
DHS-8089-ENG Deaf, DeafBlind and Hard of Hearing State Services Division Agreement for Mental Health Services
DHS-8089L-ENG Deaf, DeafBlind and Hard of Hearing State Services Division Agreement for Mental Health Services (large print)
DHS-8156-ENG Mental Health Program Client Safety Plan
DHS-8159 - Supplemental Nutrition Assistance Program (SNAP) Work Rules Notice (HMN | RUS | SOM | SPA | VIE)
DHS-8168-ENG Disability Services Division (DSD) Contact Form
DHS-8556-ENG Ineligible for Manual Reimbursement for Medicare Part B Premiums for MA-EPD enrollees
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