Lynne A. Valenti
Cabinet Secretary

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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.

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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
1EditMS-146Sterilization Consent FormDelete
1EditBRO/CPS5What I Should Know About Foster CareDelete
1EditEA-260Statement of EarningsDelete
1EditSE-405Application for Income Withholding Only ServiceDelete
1EditEA-307GSNAP Group Home Exit FormDelete
1EditBH-13Mental Health - Family Outcome ToolDelete
1EditCPS-566Foster Parent EvaluationDelete
1EditCPS-506Foster/Adoptive Parent Health ReportDelete
1EditEA-297Energy Assistance ApplicationDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditBRO/DSS3Administrative Hearings BrochureDelete
1EditCPSBackground Information for Voluntary Termination of Parental RightsDelete
1EditFACISInterstate Compact: Report on Child PlacementDelete
1EditFACISInterstate Compact: Placement Request FormDelete
1EditBRO/EA4TANF Work Program BrochureDelete
1EditBRO/ASA5Legal Services for the Elderly BrochureDelete
1EditBH-11Mental Health - Adult Outcome ToolDelete
1EditASA-634Provider Forms: Initial and Continuing Need for Care ReportDelete
1EditBRO/CPS4Mandatory Reporting of Child Abuse & Neglect BrochureDelete
1EditASA-677Prescription AssistanceDelete
1EditCCS-970Child Care Services Request For PaymentDelete
1EditBRO/DCS3Income and Wage Withholding Brochure - Information for SD Employers, Financial Institutions, and Other Payors of IncomeDelete
1EditCCSPathways to Professional DevelopmentDelete
1EditCPS-500Newborn Medical Report for Voluntary Termination of Parental RightsDelete
1EditBRO/MS1Medical Assistance Program Recipient HandbookDelete
1EditBH-17Prevention - Accreditation ApplicationDelete
1EditSE408CPApplication and Agreement for Services - Custodial Parent and/or CaretakerDelete
1EditEA-270Medical Savings Program ApplicationDelete
1EditBRO/CPS16Family Group Conferencing – Family Group Decision Making Delete
1EditCPSPlacement Resource Monthly Reporting Form Ages 14 and olderDelete
1EditBH-11cAdult SUD Discharge Outcome Tool Delete
1EditEA-301SNAP ApplicationDelete
1EditPosterConstituent Liaison Services PosterDelete
1EditBH-11fAdult MH Discharge Outcome ToolDelete
1EditEA-319Request for Administrative HearingDelete
1EditCCSElectronic Payment ExemptionsDelete
1EditBRO/ASALong-Term Care Partnership StufferDelete
1EditEA-249Disabled Children Application / Eligibility ReviewDelete
1EditSE-431AChild Support Payment Authorization FormDelete
1EditCPSDesignated Tribal Agent Request FormDelete
1EditPosterRecommendations for Exclusion from the Child Care Setting PosterDelete
1EditBRO/ASA8Assisted Living Centers: Residents Bill of Rights HandbookDelete
1EditBRO/ASA3Adult Services and Aging Programs HandbookDelete