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
1EditBH-05Hardship Considerations RefusalDelete
1EditBH-12Mental Health - Youth Outcome ToolDelete
1EditBRO/EA10SNAP for StudentsDelete
1EditBRO/CPS9Adoption Subsidy HandbookDelete
1EditBRO/DCS3Income and Wage Withholding Brochure - Information for SD Employers, Financial Institutions, and Other Payors of IncomeDelete
1EditMSTransportation Exceptions FormDelete
1EditPAPrior Authorization Forms: SynagisDelete
1EditSE408NCPApplication and Agreement for Services - Non-Custodial Parent Delete
1EditBH-17Prevention - Accreditation ApplicationDelete
1EditBRO/DCS6Voluntary Paternity Establishment Handbook and FormDelete
1EditBRO/EACommunity Action Agency HandoutDelete
1EditCPSProvider Mileage RequestDelete
1EditEA-297Energy Assistance ApplicationDelete
1EditEA-310Form for Reporting ChangesDelete
1EditEA-240Application for Resource Assessment, Long Term Care or Related Medical AssistanceDelete
1EditBRO/BH1Substance Use Disorder ServicesDelete
1EditCPS-522Request for PaymentDelete
1EditEA-208Authorization to Furnish / Release InformationDelete
1EditBRO/CPS17Family Group Conferencing – Parents Guide Delete
1EditBRO/DSS6Filing a Discrimination Complaint Brochure and FormDelete
1EditCPSIndependent Living Program BrochureDelete
1EditCPSDesignated Tribal Agent Request FormDelete
1EditBRO/RE4Medicaid Liens BrochureDelete
1EditPosterRecommendations for Exclusion from the Child Care Setting PosterDelete
1EditBRO/DSS8Notice of Privacy BrochureDelete
1EditMSInstitutional Billing ManualDelete
1EditBRO/MS4Title XIX Medical Transportation BrochureDelete
1EditEA-307GSNAP Group Home Exit FormDelete
1EditBRO/EA1Energy Saving TipsDelete
1EditBRO/DSS2Constituent Liaison Services BrochureDelete
1EditEA-270Medical Savings Program ApplicationDelete
1EditCPSPlacement Resource Monthly Reporting Form Ages 14 and olderDelete
1EditBRO/EA12Energy Assistance BrochureDelete
1EditDSSRecipient Forms: Psychiatric Residential Treatment Facility Referral FormDelete