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
1EditCPSBackground Information for Voluntary Termination of Parental RightsDelete
1EditBRO/CPS3Safe Havens BrochureDelete
1EditBRO/DCS1Child Support Modification HandbookDelete
1EditBH-05Hardship Considerations RefusalDelete
1EditBRO/EA10SNAP for StudentsDelete
1EditEA-347Application for Social Security NumberDelete
1EditEA-214SNAP 6 Month Report FormDelete
1EditDSS-CPSSafe Havens PosterDelete
1EditCPS-549Request for Screening for Substantial Reports of Abuse and Neglect (unregistered family day care providers ONLY)Delete
1EditCPS-593Permission to Screen for Reports of Abuse or NeglectDelete
1EditCCSOrientation Training Verification FormDelete
1EditASA-522Request for PaymentDelete
1EditBH-08Mental Health - IMPACT ApplicationDelete
1EditBRO/MS1Medical Assistance Program Recipient HandbookDelete
1EditRec and FraudReport Benefit FraudDelete