Lynne A. Valenti
Cabinet Secretary

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CopiesEdit the Number of CopiesDocument NumberDocument NameDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditBH-02Financial Eligibility FormDelete
1EditCCSPathways to Professional Development - Renewal ApplicationDelete
1EditEA-270Medical Savings Program ApplicationDelete
1EditSE408CPApplication and Agreement for Services - Custodial Parent and/or CaretakerDelete
1EditEA-301MAChildren and Family Medical Assistance Supplemental Application Delete
1EditBRO/DSS8Notice of Privacy BrochureDelete
1EditDSSPsychiatric Residential Treatment Facility Referral FormDelete
1EditPosterRecommendations for Exclusion from the Child Care Setting PosterDelete
1EditBRO/EA9SNAP Shoppers GuideDelete
1EditEA-260Statement of EarningsDelete
1EditEA-307GSNAP Group Home Exit FormDelete
1EditBRO/EA18Long-Term Care Partnership BrochureDelete
1EditBRO/MS4Title XIX Medical Transportation BrochureDelete
1EditEA-269Child Care Expense Billing InformationDelete
1EditBRO/RE4Medicaid Liens BrochureDelete
1EditBRO/CPS17Family Group Conferencing – Parents Guide Delete
1EditBRO/DCS2Teenage Parents Guide - How to Establish Paternity and Financial Support for your ChildDelete
1EditBRO/DSS6Filing a Discrimination Complaint Brochure and FormDelete
1EditBRO/DSS2Constituent Liaison Services BrochureDelete
1EditMS-102Provider Selection FormDelete
1EditBRO/CCS14Choosing Child Care HandbookDelete
1EditBRO/BH1Substance Use Disorder Services BrochureDelete
1EditCPSBackground Information for Voluntary Termination of Parental RightsDelete
1EditBRO/EA1Energy Saving TipsDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 5-13Delete
1EditBRO/EA3CHIP BrochureDelete
1EditMSTitle XIX Non-Emergency Transportation Payment Authorization FormDelete
1EditBH-11dAdult MH Initial Outcome ToolDelete
1EditCCSSouth Dakota Child Safety Seat Distribution ProgramDelete
1EditBRO/EA9SNAP Shoppers GuideDelete
1EditOS-950Recipient Forms: Title XIX Medical Transportation ReimbursementDelete
1EditBRO/VS1Sexual Assault BrochureDelete
1EditMSProviders: NEMT Provider AgreementDelete
1EditRec and FraudCasualty Settlement Report FormDelete
1EditPosterReportable Disease List PosterDelete
1EditEA-345AAffidavit for SNAP Work Registrants (Employment & Training)Delete
1EditBRO/EA2SNAP BrochureDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditEA-310Form for Reporting ChangesDelete
1EditBRO/CPS7Independent Living Program Education and Training Voucher BrochureDelete
1EditPAPrior Authorization Forms: GeneralDelete
1EditEA-320Self-Employment LedgerDelete
1EditRec and FraudStop Benefit Fraud InsertDelete
1EditBRO/CCS6Child Care Assistance Program BrochureDelete
1EditBRO/EBT1EBT Client HandbookDelete
1EditCPSFoster Parent HandbookDelete
1EditEA-345Affidavit for SNAP Work RegistrantsDelete
1EditBRO/EACommunity Action Agency HandoutDelete
1EditPAPrior Authorization Forms: SynagisDelete
1EditBRO/CPS15Family Group Conferencing – My Family Meeting Delete
1EditBH-063rd Party Release of Information (ROI)Delete
1EditBRO/CPS11Central Registry of Child Abuse & NeglectDelete
1EditMS-103Provider Change FormDelete
1EditCPSPotential Placement StatementDelete
1EditBRO/DCS2Teenage Parents Guide - How to Establish Paternity and Financial Support for your ChildDelete
1EditCPS-594Declaration of Prior Criminal Conviction & Military HistoryDelete
1EditSE408NCPApplication and Agreement for Services - Non-Custodial Parent Delete
1EditBH-09Mental Health - Indigent Medication ApplicationDelete
1EditBRO/RE3Estate Recovery Program BrochureDelete
1EditCPSProvider Mileage RequestDelete
1EditPAPrior Authorization Forms: Out-of State Services Delete
1EditBRO/DSS4Direct Deposit BrochureDelete
1EditBRO/DCS4National Medical Support Notice Brochure - An Employers GuideDelete
1EditCCS-950Child Care Assistance ApplicationDelete
1EditBRO/DSS8Notice of Privacy BrochureDelete
1EditEA-301MAChildren and Family Medical Assistance Supplemental Application Delete
1EditBH-01Federal Poverty Level GuidelinesDelete
1EditCPSIndependent Living Program BrochureDelete
1EditPOS/EA02Long-Term Care Partnership Fact SheetDelete
1EditBRO/CCS14Choosing Child Care HandbookDelete
1EditBRO/EA12Energy Assistance BrochureDelete