Forms & Publications :: SD Dept. of Social Services

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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Copies	Edit the Number of Copies	Document Number	Document Name	Delete
1	Edit	SE408NCP	Application and Agreement for Services - Non-Custodial Parent	Delete
1	Edit	BRO/EBT1	EBT Client Handbook	Delete
1	Edit	CCS	Electronic Payment Exemptions	Delete
1	Edit	MS-146	Sterilization Consent Form	Delete
1	Edit	BRO/CPS11	Central Registry of Child Abuse & Neglect	Delete
1	Edit	BRO/DCS4	National Medical Support Notice Brochure - An Employers Guide	Delete
1	Edit	BRO/EA2	SNAP Brochure	Delete
1	Edit	BRO/CPS7	Independent Living Program Education and Training Voucher Brochure	Delete
1	Edit	MS-103	Provider Change Form	Delete
1	Edit	EA-208	Authorization to Furnish / Release Information	Delete
1	Edit	BRO/DSS8	Notice of Privacy Brochure	Delete
1	Edit	PA	Prior Authorization Forms: Applied Behavior Analysis Therapy	Delete
1	Edit	CPS-565	Foster Parent Training & Self-Instruction	Delete
1	Edit	BRO/DSS2	Constituent Liaison Services Brochure	Delete
1	Edit	Poster	Constituent Liaison Services Poster	Delete
1	Edit	BH-08	Mental Health - IMPACT Application	Delete
1	Edit	BRO/DCS6	Voluntary Paternity Establishment Handbook and Form	Delete
1	Edit	BRO/EA12	Energy Assistance Brochure	Delete
1	Edit	BRO/CPS2	Common Sense Parenting Brochure	Delete
1	Edit	CPS	Provider Mileage Request	Delete
1	Edit	BRO/RE3	Estate Recovery Program Brochure	Delete
1	Edit	BRO/EA4	TANF Work Program Brochure	Delete
1	Edit	CCS-964	Child Care Declaration of Prior Criminal Conviction and Military History	Delete
1	Edit	EA-270	Medical Savings Program Application	Delete
1	Edit	Poster	CHIP Poster	Delete
1	Edit	BRO/DCS4	National Medical Support Notice Brochure - An Employers Guide	Delete
1	Edit	CPS-500	Newborn Medical Report for Voluntary Termination of Parental Rights	Delete
1	Edit	CPS-508	Reference Form - Adoption / Foster / Kinship Care	Delete
1	Edit	MS	Providers: NEMT Provider Agreement	Delete
1	Edit	CPS	Foster Parent Handbook	Delete
1	Edit	BRO/CPS9	Adoption Subsidy Handbook	Delete
1	Edit	EA-345A	Affidavit for SNAP Work Registrants (Employment & Training)	Delete
1	Edit	CPS-522	Request for Payment	Delete
1	Edit	CPS-593	Permission to Screen for Reports of Abuse or Neglect	Delete
1	Edit	EA-298	Weatherization Application	Delete
1	Edit	MS	Hysterectomy Acknowledgement of Information	Delete
1	Edit	Rec and Fraud	Estate Recovery Program Petition for Limitation	Delete
1	Edit	BRO/EA9	SNAP Shoppers Guide	Delete
1	Edit	CPS	Placement Resource Monthly Reporting Form Ages 5-13	Delete
1	Edit	BRO/MS3	Well-Child Care Brochure	Delete
1	Edit		Recipient Forms: HIPAA Privacy Consent Form	Delete
1	Edit	BH-11d	Adult MH Initial Outcome Tool	Delete
1	Edit	BRO/EBT1	EBT Client Handbook	Delete