 DHS-0035-ENG State Agency Appeals Summary
DHS-1728F-ENG Vendor's Invoice
DHS-1795-ENG SSI Interim Assistance Authorization
DHS-1795A-ENG Interim Assistance Authorization (non-SSI)
DHS-2630-ENG Alternative Care Program Eligibility Worksheet
DHS-2630A-ENG Alternative Care Program Eligibility Worksheet Type A
DHS-2868-ENG MHCP Hospice Transaction Form
DHS-3427-ENG LTC Screening Document - AC, BI, CAC, CADI, ECS, EW, MHM, MSC+, MSHO
DHS-3531-ENG Application for Medical Assistance for Long-Term-Care Services (MA-LTC) (SPA)
DHS-3879-ENG Moving Home Minnesota (MHM) - Transition Planning, Transition Coordination and Demonstration Case Management - Provider Assurance Statement
DHS-4005L-ENG Minnesota Access to Communication Technology Application Large Print
DHS-4016-ENG MHCP Individual Provider Enrollment Application
DHS-4163 - Client responsibilities and rights (HMN | RUS | SOM | SPA | VIE)
DHS-4719-ENG Guidelines for Developing Policies and Procedures - Licensed Child Care Centers
DHS-5274 - Minnesota Child Care Assistance Program Redetermination Form (HMN | RUS | SOM | SPA | VIE)
DHS-6235-ENG Minnesota Youth in Transition Database (MNYTD) Survey
DHS-6235A-ENG Minnesota Youth in Transition Database (MNYTD) Survey - Additional Contact Sheet
DHS-6451-ENG Special Needs BasicCare (SNBC) Choice Form
DHS-6683-ENG Essential Community Supports Program (ECS) Eligibility Worksheet
DHS-6683A-ENG Essential Community Supports Program (ECS) Eligibility Worksheet Type A
DHS-6696-SPA MNsure Application for Health Coverage and Help Paying Costs
DHS-6810G-ENG Positive Support Transition Plan (PTSP) Quality Checklist
DHS-7118-ENG Universal Licensing Application
DHS-7414B-ENG Legal Nonlicensed (LNL) Child Care Emergency Plan
DHS-7618-ENG Home and Community-Based Services (HCBS) Settings Provider Assurance Statement
DHS-7867-ENG Child Care Assistance Program Legal Nonlicensed Provider Monitoring Checklist
DHS-7867A-ENG Child Care Assistance Program - Monitoring Visit Summary
DHS-8415-ENG Qualified Individual Request Form
DHS-8620-ENG Request for Special Diet Information
DHS-8666-ENG School-Based Treatment Supervision Plan
DHS-8675-ENG External Partner Conflict of Interest Disclosure Form
DHS-8675A-ENG COI Disclosure Form for Competitive Grant Reviews
DHS-8382 - Qualified Individual Contract Application
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