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	BH-07	Mental Health - Accreditation Application	Delete
1	Edit	BRO/RE1	Stop Benefit Fraud Brochure	Delete
1	Edit	BRO/BH4	Substance Use Disorder Involuntary Commitment Process	Delete
1	Edit	SE408NCP	Application and Agreement for Services - Non-Custodial Parent	Delete
1	Edit	EA-324	Wage Verification	Delete
1	Edit	CCS	Pathways to Professional Development - Career Lattice Application Form	Delete
1	Edit	PA	Prior Authorization Form: Incontinence Supply CHOICES Waiver	Delete
1	Edit	MISC/BH1	South Dakota Community Mental Health Center Flyer	Delete
1	Edit	CPS-508	Reference Form - Adoption / Foster / Kinship Care	Delete
1	Edit	SE408CP	Application and Agreement for Services - Custodial Parent and/or Caretaker	Delete
1	Edit	BRO/CPS17	Family Group Conferencing – Parents Guide	Delete
1	Edit	FACIS	Interstate Compact: Report on Child Placement	Delete
1	Edit	BRO/CPS4	Mandatory Reporting of Child Abuse & Neglect Brochure	Delete
1	Edit	EA-214	TANF 6 Month Report Form	Delete
1	Edit	CPS	Placement Resource Monthly Reporting Form Ages 14 and older	Delete
1	Edit	CPS-566	Foster Parent Evaluation	Delete
1	Edit	Poster	Constituent Liaison Services Poster	Delete
1	Edit	BRO/EA16	Medical Assistance for Children and Families: IHS Specific	Delete
1	Edit	BH-13a	Family SUD Initial Outcome Tool	Delete
1	Edit	BH-11c	Adult SUD Discharge Outcome Tool	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	BH-17	Prevention - Accreditation Application	Delete
1	Edit	BRO/DCS8	Child Support Parent Handbook	Delete
1	Edit	CCS	Electronic Payment Exemptions	Delete
1	Edit	BH-12a	Youth SUD Initial Outcome Tool	Delete
1	Edit	EA-208	Authorization to Furnish / Release Information	Delete
1	Edit	BRO/DSS8	Notice of Privacy Brochure	Delete
1	Edit	EA-320	Self-Employment Ledger	Delete
1	Edit	BH-13c	Family SUD Discharge Outcome Tool	Delete
1	Edit	BH-11e	Adult MH Update Outcome Tool	Delete
1	Edit	CPS-500	Newborn Medical Report for Voluntary Termination of Parental Rights	Delete
1	Edit	CPS-593	Permission to Screen for Reports of Abuse or Neglect	Delete
1	Edit	CPS-565	Foster Parent Training & Self-Instruction	Delete
1	Edit	EA-319	Request for Administrative Hearing	Delete
1	Edit	BRO/DSS2	Constituent Liaison Services Brochure	Delete
1	Edit	DSS-CPS	Safe Havens Poster	Delete
1	Edit	CCS-964	Child Care Declaration of Prior Criminal Conviction and Military History	Delete
1	Edit	BH-12c	Youth SUD Discharge Outcome Tool	Delete
1	Edit	BRO/EA12	Energy Assistance Brochure	Delete
1	Edit	BRO/RE3	Estate Recovery Program Brochure	Delete
1	Edit	EA-208	Authorization to Furnish / Release Information	Delete
1	Edit	BRO/CPS2	Common Sense Parenting Brochure	Delete
1	Edit	BRO/EA4	TANF Work Program Brochure	Delete
1	Edit	EA-270	Medical Savings Program Application	Delete
1	Edit	BRO/RE4	Medicaid Liens Brochure	Delete
1	Edit	BH-13e	Family MH Update Outcome Tool	Delete
1	Edit	EA-265	Request for Long-Term Care or Home Community Based Services Waiver Assistance	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	CPS	Provider Mileage Request	Delete
1	Edit	Poster	Reportable Disease List Poster	Delete
1	Edit	BRO/DSS3	Administrative Hearings Brochure	Delete
1	Edit	MS	Medicaid Non-Emergency Travel (NEMT) Payment Authorization Form	Delete
1	Edit	CPS-506	Foster/Adoptive Parent Health Report	Delete
1	Edit	EA-347	Application for Social Security Number	Delete
1	Edit	SE-415	Petition for Modification Form	Delete
1	Edit	PA	Prior Authorization Form: Incontinence Supply Family Support 360 Waiver	Delete
1	Edit	FACIS	Interstate Compact: Placement Request Form	Delete