Lynne A. Valenti
Cabinet Secretary

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CopiesEdit the Number of CopiesDocument NumberDocument NameDelete
1EditCPSDesignated Tribal Agent Request FormDelete
1EditBRO/MS4Title XIX Medical Transportation BrochureDelete
1EditCCSPathways to Professional Development - Career Lattice Application FormDelete
1EditOS-954Client Authorized Debit for Repayment of OverissuanceDelete
1EditMSProviders: Adult Services & Aging Provider AgreementDelete
1EditEA-231Child Support Enforcement ReferralDelete
1EditBRO/EA8Medicaid Spousal Care HandbookDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 0-4Delete
1EditBRO/DCS1Child Support Modification HandbookDelete
1EditSE-431AChild Support Payment Authorization FormDelete
1EditBH-04102b Hardship ConsiderationsDelete
1EditMSProviders: NEMT Provider AgreementDelete
1EditEA-249Disabled Children Application / Eligibility ReviewDelete
1EditEA-269Child Care Expense Billing InformationDelete
1EditEA-231Recipient Forms: Child Support Enforcement ReferralDelete
1EditBRO/RE4Medicaid Liens BrochureDelete
1EditMSPrior Authorization Forms: General Prior Authorization RequestDelete
1EditBRO/ASA9Domestic Violence BrochureDelete
1EditBH-09Mental Health - Indigent Medication ApplicationDelete
1EditBRO/MS1Medical Assistance Program Recipient HandbookDelete
1EditBH-17Prevention - Accreditation ApplicationDelete
1EditEA-347Application for Social Security NumberDelete
1EditPosterCHIP PosterDelete
1EditBRO/DCS3Income and Wage Withholding Brochure - Information for SD Employers, Financial Institutions, and Other Payors of IncomeDelete
1EditPosterCHIP PosterDelete
1EditCPSBackground Information for Voluntary Termination of Parental RightsDelete