 DHS-2338-ENG (PDF) Cooperation with Child Support
DHS-2759-ENG (PDF) Notice About Income and Eligibility Verification System and Work Reporting System
DHS-3741: Your Appeal Rights [ HMN (PDF) | RUS (PDF) | SOM (PDF) | SPA (PDF) | VIE (PDF) ]
DHS-4258D-ENG Home Study Assessment
DHS-4776-ENG (PDF) Family Investigation Notice of Reconsideration - Affirmed
DHS-4839E: Notice of Privacy Practices for all health care programs (except MFPP) (insert) [ HMN (PDF) | ORM (PDF) | RUS (PDF) | SOM (PDF) | SPA (PDF) | VIE (PDF) ]
DHS-4897-ENG (PDF) Work Activity Verification Log
DHS-4931-ENG (PDF) Unreimbursed and/or uninsured medical/dental expenses packet
DHS-5139-ENG (PDF) Case Corrective Action Form - Minnesota Medical Eligibility Audit
DHS-5788A-ENG CDCS Community Support Plan
DHS-6248-ENG (PDF) Voluntary Foster Care Agreement for Youth Ages 18-21
DHS-6355-ENG (PDF) DHS Foster Care Candidacy Statistical Report
DHS-6762D-ENG (PDF) Minnesota Adult Protection SDM® Initial Safety Assessment
DHS-7651B-ENG Electronic Visit Verification (EVV) - Provider Corrective Action Plan (CAP)
DHS-7940-ENG (PDF) Confidential address options during court action
DHS-7990-ENG (PDF) Pediatric Symptom Checklist Parent and Youth Screening Tool Q38
DHS-8064-ENG Title IV-E Northstar Adoption Assistance Eligibility Determination for Children Placed Privately for Adoption
DHS-8068: Foster Care Sibling Bill of Rights [ HMN (PDF) | RUS (PDF) | SOM (PDF) | SPA (PDF) | VIE (PDF) ]
DHS-8091-ENG Minnesota Child Care Assistance Program Data Request Form
DHS-8139-ENG (PDF) Sex trafficked, commercially sexually exploited (STY), and/or at risk youth checklist
DHS-8157-ENG Elderly Waiver Customized Living Services Disproportionate Share Facility Application
DHS-8569-ENG (PDF) African American Child and Family Well-Being Unit RFP Reviewer Application
DHS-8620-ENG (PDF) Request for Special Diet Information
DHS-8853-ENG (PDF) Talent Release Form (DHS Employee)
DHS-8854-ENG (PDF) Talent Release Form (External)
DHS-8899-ENG Treatment Supervisor Attestation Form
DHS-8901-ENGTreatment Supervision Limit Exception Request: Adult Rehabilitative Mental Health Services (ARMHS) and Children's Therapeutic Services and Supports (CTSS)
DHS-3426 OBRA Level I Criteria – Screening for Developmental Disabilities or Mental Illness
DHS-6532 CDCS Community Support Plan
DHS-6791B MnCHOICES Community Support Plan with Coordinated Services and Supports Form
DHS-7093 Application for Certification as a Behavioral Health Home (BHH)
DHS-7093A Request to apply for behavioral health home (BHH) services certification
DHS-7185 Case Manager's Recipient Information Form
DHS-7338 Request for private data about yourself
DHS-7611A Person's evaluation of his or her coordinated service and supports plan (CSSP) (offline version)
DHS-7611B Person's evaluation of his or her service provider for day services (offline version)
DHS-7611C Person's evaluation of his or her service provider for non-day or non-residential services (offline version)
DHS-7611D Person's evaluation of his or her service provider for residential services (offline version)
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