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
1EditBRO/EA1Energy Saving TipsDelete
1EditBH-12Mental Health - Youth Outcome ToolDelete
1EditBRO/CCS3Registration & Licensure of Child Care EnvironmentsDelete
1EditEA-240Application for Long Term Care or Related Medical AssistanceDelete
1EditBRO/CPS9Adoption Subsidy HandbookDelete
1EditASA-659Physician Report - OrderDelete
1EditEA-305Boarding School-Institution DocumentationDelete
1EditBH-11bAdult SUD Update Outcome ToolDelete
1EditBH-03102a Hardship Considerations Delete
1EditDSS-ORFI-831Estate Recovery Notification of Death FormDelete
1EditDSSPsychiatric Residential Treatment Facility Referral FormDelete
1EditPAPrior Authorization Forms: Private Duty Nursing & Extended Home Health ServicesDelete
1EditEA-269Child Care Expense Billing InformationDelete
1EditEA-240Application for Long Term Care or Related Medical AssistanceDelete