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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
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditEA-265Request for Long-Term Care or Home Community Based Services Waiver AssistanceDelete
1EditBRODSS08Notice of Privacy BrochureDelete
1EditEA-214TANF 6 Month Report FormDelete
1EditCCSElectronic Payment ExemptionsDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 14 and olderDelete
1EditBRODSS03Administrative Hearings BrochureDelete
1EditFLYRBH01South Dakota Community Mental Health Center FlyerDelete
1Edit- South Dakota Medicaid Handicapping Labio-Langual Deviations Form (HLD Index)Delete
1EditMS-146Sterilization Consent FormDelete
1EditBROEA01Energy Saving TipsDelete
1EditPAPrior Authorization Forms: SynagisDelete
1EditCCSPayment Authorization FormDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 5-13Delete
1EditRec and FraudEstate Recovery Program Petition for LimitationDelete
1EditEA-345AAffidavit for SNAP Work Registrants (Employment & Training)Delete
1EditCCS-950Child Care Assistance ApplicationDelete
1EditEA-320Self-Employment LedgerDelete