Lynne A. Valenti
Cabinet Secretary

DSS Mobile Logo Mobile Menu Button

Order Forms and Publications

Ready to Check Out?

Below you will find the selected forms and/or publications for this order. You will need to indicate the quantity you want to receive in the box next to the document number. After you have entered the quantity, click "Update" in the previous box. If you wish to remove a form or publication, simply click on the link that states "Delete." Once you have entered the quantity for each form or publication, click the "Proceed" button at the bottom.

All fields are required.

The information being sent to you is free.

If you want to continue looking for more forms and/or publications, click here.

When entering the number of copies - use only numbers, no commas.

CopiesEdit the Number of CopiesDocument NumberDocument NameDelete
1EditCPSProvider Mileage RequestDelete
1EditEA-320Self-Employment LedgerDelete
1EditCPSFoster Parent HandbookDelete
1EditBRO/CPS7Independent Living Program Education and Training Voucher BrochureDelete
1EditBH-09Mental Health - Indigent Medication ApplicationDelete
1EditEA-301Economic Assistance ApplicationDelete
1EditEA-270Medical Savings Program ApplicationDelete
1EditEA-214TANF 6 Month Report FormDelete
1EditSE408NCPApplication and Agreement for Services - Non-Custodial Parent Delete
1EditEA-345AAffidavit for SNAP Work Registrants (Employment & Training)Delete
1EditBRO/EA12Energy Assistance BrochureDelete
1EditBRO/CPS11Central Registry of Child Abuse & NeglectDelete
1EditBRO/DSS4Direct Deposit BrochureDelete
1EditCPSIndependent Living Program BrochureDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditCCSPathways to Professional Development - Career Lattice Application FormDelete
1EditBRO/EALong-Term Care Partnership Fact SheetDelete
1EditBH-18Mental Health - Indigent Medication Update - Extension Form 1.0Delete
1EditBRO/DSS2Constituent Liaison Services BrochureDelete
1EditPosterReportable Disease List PosterDelete
1EditPAPrior Authorization Forms: Applied Behavior Analysis TherapyDelete
1EditCPSPotential Placement StatementDelete
1EditCPS-565Foster Parent Training & Self-InstructionDelete
1EditCPS-594Declaration of Prior Criminal Conviction & Military HistoryDelete
1EditMSProfessional Services Billing ManualDelete
1EditBRO/CCS6Child Care Assistance Program BrochureDelete
1EditCCSSouth Dakota Child Safety Seat Distribution ProgramDelete
1EditBH-19Substance Use Disorder High Intensity Referral FormDelete
1EditBRO/CPS17Family Group Conferencing – Parents Guide Delete
1EditEA-310Form for Reporting ChangesDelete
1EditBH-14Substance Abuse - Accreditation ApplicationDelete
1EditEA-231Recipient Forms: Child Support Enforcement ReferralDelete
1EditBRO/RE4Medicaid Liens BrochureDelete
1EditBRO/CCS14Choosing Child Care HandbookDelete
1EditMSProviders: NEMT Provider AgreementDelete
1EditBRO/EA2SNAP BrochureDelete
1EditMSPrior Authorization Forms: BRCA Prior AuthorizationDelete
1EditBH-01Federal Poverty Level GuidelinesDelete
1EditMS-103Provider Change FormDelete