M. Greg DeSautel, MD
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
1EditBRO/RE1Stop Benefit Fraud BrochureDelete
1EditSE408NCPApplication and Agreement for Services - Non-Custodial Parent Delete
1EditBRO/CPS17Family Group Conferencing – Parents Guide Delete
1EditFACISInterstate Compact: Report on Child PlacementDelete
1EditBRO/CPS4Mandatory Reporting of Child Abuse & Neglect BrochureDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 14 and olderDelete
1EditCPS-566Foster Parent EvaluationDelete
1EditPosterConstituent Liaison Services PosterDelete
1EditBRO/EA16Medical Assistance for Children and Families: IHS SpecificDelete
1EditBRO/CPS1Child Protection Services BookletDelete
1EditPosterCHIP PosterDelete
1EditBRO/EA2SNAP BrochureDelete
1EditBRO/CPS7Independent Living Program Education and Training Voucher BrochureDelete
1EditBRO/EA8Medicaid Spousal Care HandbookDelete
1EditBH-17Prevention - Accreditation ApplicationDelete
1EditBRO/DCS8Child Support Parent HandbookDelete
1EditRec and FraudReport Benefit FraudDelete
1EditMS-103Provider Change FormDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditBRO/DSS8Notice of Privacy BrochureDelete
1EditCPS-500Newborn Medical Report for Voluntary Termination of Parental RightsDelete
1EditCPS-593Permission to Screen for Reports of Abuse or NeglectDelete
1EditCPS-565Foster Parent Training & Self-InstructionDelete
1EditEA-319Request for Administrative HearingDelete
1EditBRO/DSS2Constituent Liaison Services BrochureDelete
1EditBH-02Financial Eligibility FormDelete
1EditDSS-CPSSafe Havens PosterDelete
1EditBRO/EA12Energy Assistance BrochureDelete
1EditBRO/RE3Estate Recovery Program BrochureDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditBRO/CPS2Common Sense Parenting BrochureDelete
1EditBRO/EA4TANF Work Program BrochureDelete
1EditEA-270Medical Savings Program ApplicationDelete
1EditBRO/RE4Medicaid Liens BrochureDelete
1EditEA-265Request for Long-Term Care or Home Community Based Services Waiver AssistanceDelete
1EditPosterCHIP PosterDelete
1EditBRO/DCS4National Medical Support Notice Brochure - An Employers GuideDelete
1EditPosterReportable Disease List PosterDelete
1EditBRO/DSS3Administrative Hearings BrochureDelete
1EditCPS-506Foster/Adoptive Parent Health ReportDelete
1EditFACISInterstate Compact: Placement Request FormDelete
1EditBRO/EACommunity Action Agency HandoutDelete
1EditMSProviders: NEMT Provider AgreementDelete
1EditBRO/EA11Weatherization Assistance BrochureDelete
1EditCPSBackground Information for Voluntary Termination of Parental RightsDelete
1EditEA-345AAffidavit for SNAP Work Registrants (Employment & Training)Delete
1EditBRO/DCS6Voluntary Paternity Establishment Handbook and FormDelete
1EditBRO/CCS3Registration & Licensure of Child Care EnvironmentsDelete
1EditBRO/EA14Medical Assistance for Children and FamiliesDelete
1EditEA-301MAChildren and Family Medical Assistance Supplemental Application Delete
1EditBH-14Substance Abuse - Accreditation ApplicationDelete
1EditCPS-522Request for PaymentDelete
1EditMSHysterectomy Acknowledgement of InformationDelete
1EditRec and FraudEstate Recovery Program Petition for LimitationDelete
1EditBH-08Mental Health - IMPACT ApplicationDelete
1EditBRO/EA18Long-Term Care Partnership BrochureDelete
1EditBRO/EA9SNAP Shoppers GuideDelete
1EditCPSDesignated Tribal Agent Request FormDelete
1EditBRO/MS1Medical Assistance Program Recipient HandbookDelete
1EditBRO/MS3Well-Child Care BrochureDelete
1EditBRO/CPS18Family Group Conferencing – Provider Guide Delete
1EditCPSPlacement Resource Monthly Reporting Form Ages 5-13Delete
1EditBRO/CPS3Safe Havens BrochureDelete
1EditBH-11dAdult MH Initial Outcome ToolDelete
1EditBRO/EBT1EBT Client HandbookDelete
1EditBRO/DSS9DSS HandbookDelete
1EditBRO/EA10SNAP for StudentsDelete
1EditBRO/DSS6Filing a Discrimination Complaint Brochure and FormDelete
1EditBRO/EA5Medicare Savings Program BrochureDelete
1EditBH-01Federal Poverty Level GuidelinesDelete
1EditBRO/DCS1Child Support Modification HandbookDelete
1EditBRO/CPS11Central Registry of Child Abuse & NeglectDelete
1EditCCSPayment Authorization FormDelete
1EditEA-214SNAP 6 Month Report FormDelete
1EditPAPrior Authorization Forms: SynagisDelete
1EditEA-320Self-Employment LedgerDelete
1EditRec and FraudStop Benefit Fraud InsertDelete
1EditBH-03102a Hardship Considerations Delete
1EditBRO/DCS3Income and Wage Withholding Brochure - Information for SD Employers, Financial Institutions, and Other Payors of IncomeDelete
1EditEA-240DApplication for Medical Assistance for Workers with DisabilitiesDelete
1EditBRO/CCS6Child Care Assistance Program BrochureDelete
1EditBRO/DSS4Direct Deposit BrochureDelete
1EditPOS/EA02Long-Term Care Partnership Fact SheetDelete
1EditBRO/MS1Medical Assistance Program Recipient HandbookDelete
1EditMSCertificate of Medical NecessityDelete
1EditBRO/MS4Title XIX Medical Transportation BrochureDelete
1EditCCSSouth Dakota Child Safety Seat Distribution ProgramDelete
1EditBRO/DCS2Teenage Parents Guide - How to Establish Paternity and Financial Support for your ChildDelete
1EditCPSIndependent Living Program BrochureDelete