Forms & Publications :: SD Dept. of Social Services

Laurie Gill
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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Copies	Edit the Number of Copies	Document Number	Document Name	Delete
1	Edit	BRO/RE1	Stop Benefit Fraud Brochure	Delete
1	Edit	BRO/BH4	Substance Use Disorder Involuntary Commitment Process	Delete
1	Edit	BRO/CPS17	Family Group Conferencing – Parents Guide	Delete
1	Edit	BRO/CPS4	Mandatory Reporting of Child Abuse & Neglect Brochure	Delete
1	Edit	Poster	Constituent Liaison Services Poster	Delete
1	Edit	BRO/EA16	Medical Assistance for Children and Families: IHS Specific	Delete
1	Edit	BRO/CPS1	Child Protection Services Booklet	Delete
1	Edit	Poster	CHIP Poster	Delete
1	Edit	BRO/EA2	SNAP Brochure	Delete
1	Edit	CCS	Orientation Training Verification Form	Delete
1	Edit	SE-492	Notice of Shared Medical Expenses	Delete
1	Edit	BRO/CPS7	Independent Living Program Education and Training Voucher Brochure	Delete
1	Edit	BRO/EA8	Medicaid Spousal Care Handbook	Delete
1	Edit	BRO/DCS8	Child Support Parent Handbook	Delete
1	Edit	BRO/DSS8	Notice of Privacy Brochure	Delete
1	Edit	EA-320	Self-Employment Ledger	Delete
1	Edit	BRO/DSS2	Constituent Liaison Services Brochure	Delete
1	Edit	DSS-CPS	Safe Havens Poster	Delete
1	Edit	BRO/EA12	Energy Assistance Brochure	Delete
1	Edit	BRO/RE3	Estate Recovery Program Brochure	Delete
1	Edit	BRO/CPS2	Common Sense Parenting Brochure	Delete
1	Edit	BRO/EA4	TANF Work Program Brochure	Delete
1	Edit	BRO/RE4	Medicaid Liens Brochure	Delete
1	Edit	Poster	CHIP Poster	Delete
1	Edit	OS-954	Client Authorized Debit for Repayment of Overissuance	Delete
1	Edit	BH-04	102b Hardship Considerations	Delete
1	Edit	BRO/DCS4	National Medical Support Notice Brochure - An Employers Guide	Delete
1	Edit	Poster	Reportable Disease List Poster	Delete
1	Edit	DSS	Psychiatric Residential Treatment Facility Referral Form	Delete
1	Edit	BRO/DSS3	Administrative Hearings Brochure	Delete
1	Edit	BRO/EA	Community Action Agency Handout	Delete
1	Edit	DSS-CCS	Rate Declaration Form	Delete
1	Edit	SE-406	Application for Location Only Services	Delete
1	Edit	BRO/EA11	Weatherization Assistance Brochure	Delete
1	Edit	BH-18	Substance Use Disorder High Intensity Referral Form	Delete
1	Edit	BRO/DCS6	Voluntary Paternity Establishment Handbook and Form	Delete
1	Edit	BRO/CCS3	Registration & Licensure of Child Care Environments	Delete
1	Edit	BRO/EA14	Medical Assistance for Children and Families	Delete
1	Edit	CPS-549	Request for Screening for Substantial Reports of Abuse and Neglect (unregistered family day care providers ONLY)	Delete
1	Edit	BRO/EA18	Long-Term Care Partnership Brochure	Delete
1	Edit	BRO/EA9	SNAP Shoppers Guide	Delete
1	Edit		Recipient Forms: HIPAA Privacy Consent Form	Delete
1	Edit	BRO/MS1	Medical Assistance Program Recipient Handbook	Delete
1	Edit	BRO/MS3	Well-Child Care Brochure	Delete
1	Edit	BRO/CPS18	Family Group Conferencing – Provider Guide	Delete
1	Edit	EA-301	Economic Assistance Application	Delete
1	Edit	BRO/CPS3	Safe Havens Brochure	Delete
1	Edit	BRO/EBT1	EBT Client Handbook	Delete
1	Edit	BRO/DSS9	DSS Handbook	Delete
1	Edit	CPS	Independent Living Program Education and Training Voucher	Delete
1	Edit	BRO/EA10	SNAP for Students	Delete
1	Edit	BRO/DSS6	Filing a Discrimination Complaint Brochure and Form	Delete
1	Edit	BRO/EA5	Medicare Savings Program Brochure	Delete
1	Edit	BRO/DCS1	Child Support Modification Handbook	Delete
1	Edit	BRO/CPS11	Central Registry of Child Abuse & Neglect	Delete
1	Edit	EA-208	Authorization to Furnish / Release Information	Delete
1	Edit	Rec and Fraud	Stop Benefit Fraud Insert	Delete
1	Edit	EA-269	Child Care Expense Billing Information	Delete
1	Edit	BRO/DCS3	Income and Wage Withholding Brochure - Information for SD Employers, Financial Institutions, and Other Payors of Income	Delete
1	Edit	EA-240D	Application for Medical Assistance for Workers with Disabilities	Delete
1	Edit	BRO/CCS6	Child Care Assistance Program Brochure	Delete
1	Edit	BRO/DSS4	Direct Deposit Brochure	Delete
1	Edit	MS-146	Sterilization Consent Form	Delete
1	Edit	BRO/EA1	Energy Saving Tips	Delete
1	Edit	POS/EA02	Long-Term Care Partnership Fact Sheet	Delete
1	Edit	BRO/MS1	Medical Assistance Program Recipient Handbook	Delete
1	Edit	BRO/MS4	Medicaid Non-Emergency Medical Travel Brochure	Delete
1	Edit	CCS	Pathways to Professional Development - Renewal Application	Delete
1	Edit	FSSA	Children and Family Medical Assistance Application	Delete
1	Edit	CCS	South Dakota Child Safety Seat Distribution Program	Delete
1	Edit	BRO/DCS2	Teenage Parents Guide - How to Establish Paternity and Financial Support for your Child	Delete
1	Edit	CPS	Independent Living Program Brochure	Delete
1	Edit	CPS-594	Declaration of Prior Criminal Conviction & Military History	Delete
1	Edit	BRO/CCS14	Choosing Child Care Handbook	Delete
1	Edit	BRO/CPS15	Family Group Conferencing – My Family Meeting	Delete
1	Edit	DSS	Guide to Administrative Hearings Procedure	Delete
1	Edit	PA	Prior Authorization Forms: Out-of State Services	Delete