Forms published to eDocs (February 2025)

Minnesota Department of Human Services logo

Forms published to eDocs

February 2025

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DHS-0188-ENG Post-placement Assessment and Report to Court

DHS-2402B - Change Report Form for the Supplemental Nutrition Assistance Program (HMN | RUS | SOM | SPA | VIE)

DHS-3159C - Minnesota Voluntary Recognition of Parentage Spouse's Non-Parentage Statement (HMN | SOM | SPA)

DHS-3727 - Combined Annual Renewal For Certain Populations (HMN | RUS | SOMSPA | VIE)

DHS-4602-ENG CCAP Medical Condition Documentation Form

DHS-5820-ENG Disability Waiver Rates System Exception Request

DHS-6893T - Worker Information form for CFSS budget model (HMN | RUS | SOMSPA | VIE)

DHS-7120C-ENG Early Intensive Developmental and Behavioral Intervention (EIDBI) Qualified Supervising Professionals (QSP) Assurance Statement

DHS-7967-ENG Housing Transition and Housing Sustaining Provider Assurance Statement

DHS-8058-SPA Deaf, DeafBlind and Hard of Hearing State Services Division Consent to Telehealth Services

DHS-8086-SPA Mental Health Program Release of Information Consent

DHS-8087-SPA Deaf, DeafBlind and Hard of Hearing State Services Division Terms of Service and Notice of Privacy Practices

DHS-8089-SPA Deaf, DeafBlind and Hard of Hearing State Services Division Agreement for Mental Health Services

DHS-8097-ENG Qualified Residential Treatment Program (QRTP) Placement Assessment and Recommendation Form

DHS-8496-ENG SNAP Employment and Training Eligibility and Enrollment Form

DHS-8555 - Worker Information form for CFSS budget model (HMN | RUS | SOM | SPA | VIE)

DHS-8556-ENG Ineligible for Manual Reimbursement for Medicare Part B Premiums for MA-EPD enrollees (HMN | RUS | SOM | SPA | VIE)

DHS-8562-ENG Recuperative Care Professional Provider Acknowledgement

 

Form(s) made obsolete

None

 


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