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
1EditCPS-549Request for Screening for Substantial Reports of Abuse and Neglect (unregistered family day care providers ONLY)Delete
1EditBRO/DCS1Child Support Modification HandbookDelete
1EditBRO/EA12Energy Assistance BrochureDelete
1EditCPSDesignated Tribal Agent Request FormDelete
1EditDSS-ORFI-831Estate Recovery Notification of Death FormDelete
1EditBRO/BH2Mental Health Services BrochureDelete
1EditBRO/RE1Stop Benefit Fraud BrochureDelete
1EditPAPrior Authorization Forms: Durable Medical Equipment and NutritionDelete
1EditDSS-CPSSafe Havens PosterDelete
1EditBRO/EA14Medical Assistance for Children and FamiliesDelete
1EditCCSPayment Authorization FormDelete
1EditDSS-CCSRate Declaration FormDelete
1EditBRO/BH1Substance Use Disorder Services BrochureDelete
1EditBRO/DCS2Teenage Parents Guide - How to Establish Paternity and Financial Support for your ChildDelete
1EditEA-270Medical Savings Program ApplicationDelete
1EditBRO/CCS14Choosing Child Care HandbookDelete
1EditBRO/DSS2Constituent Liaison Services BrochureDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditBRO/DSS8Notice of Privacy BrochureDelete