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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CopiesEdit the Number of CopiesDocument NumberDocument NameDelete
1EditEA-345Affidavit for SNAP Work RegistrantsDelete
1EditEA-345AAffidavit for SNAP Work Registrants (Employment & Training)Delete
1EditBH-18Substance Use Disorder High Intensity Referral FormDelete
1EditMSProviders: NEMT Provider AgreementDelete
1EditBH-07Mental Health - Accreditation ApplicationDelete
1EditCPSPotential Placement StatementDelete
1EditBH-04102b Hardship ConsiderationsDelete
1EditMSCertificate of Medical NecessityDelete
1EditPosterCHIP PosterDelete
1EditBRO/BH1Substance Use Disorder Services BrochureDelete
1EditEA-305Boarding School-Institution DocumentationDelete
1EditCPS-566Foster Parent EvaluationDelete
1EditRec and FraudEstate Recovery Program Petition for LimitationDelete
1EditCCSOrientation Training Verification FormDelete
1EditBRO/EA8Medicaid Spousal Care HandbookDelete
1EditDSSGuide to Administrative Hearings ProcedureDelete
1EditBRO/MS6Health Home BrochureDelete
1EditRec and FraudReport Benefit FraudDelete