Forms & Publications :: SD Dept. of Social Services

Cabinet Secretary
Matt Althoff

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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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Copies	Edit the Number of Copies	Document Number	Document Name	Delete
1	Edit	CPS-522	Request for Payment	Delete
1	Edit	CPS 07	Independent Living Program Education and Training Voucher Brochure	Delete
1	Edit	CPS 10	Independent Living Program Brochure	Delete
1	Edit	CPS-100A	FACIS Interstate Compact: Placement Request Form	Delete
1	Edit	DCS 06	Voluntary Paternity Establishment Handbook and Form	Delete
1	Edit	BH 15	Criminal Justice Initiative Flyer	Delete
1	Edit	SE-431A	Child Support Payment Authorization Form	Delete
1	Edit	NEMT-964	Non-Emergency Medical Travel (NEMT) HIPAA Authorization	Delete
1	Edit	PA-100	Prior Authorization Forms: General	Delete
1	Edit	NEMT-952	Medicaid Non-Emergency Travel (NEMT) Payment Authorization Form	Delete
1	Edit	CCS-970	Child Care Services Request For Payment	Delete
1	Edit	CPS-100A	FACIS Interstate Compact: Placement Request Form	Delete
1	Edit	PA-103	Prior Authorization Forms: Synagis	Delete
1	Edit	MS 07	Premium Assistance Rack Card	Delete
1	Edit	MS 03	Well-Child Care Brochure	Delete
1	Edit	BH 16	Pregnancy Alcohol Flyer	Delete
1	Edit	BH 24	Behavioral Health Resources Flyer	Delete
1	Edit	OLA 03	Office of Licensing and Accreditation Brochure	Delete
1	Edit	EA-208	Authorization to Furnish / Release Information	Delete
1	Edit	EA 09	SNAP Shoppers Guide	Delete
1	Edit	EA-307G	SNAP Group Home Exit Form	Delete
1	Edit	CPS-500	Newborn Medical Report for Voluntary Termination of Parental Rights	Delete
1	Edit	ENERGY	Vendor Information: Direct Deposit	Delete
1	Edit	BH 10	South Dakota Community Mental Health Center Flyer	Delete
1	Edit	DSS 08	Notice of Privacy Brochure	Delete
1	Edit	EA-240	Application for Resource Assessment, Long Term Care or Related Medical Assistance	Delete
1	Edit	CPS-565	Foster Parent Training & Self-Instruction	Delete
1	Edit	CPS-533	Adoption Registry Form	Delete
1	Edit	EA-270	Medicare Savings Program Application	Delete
1	Edit	EA 09	SNAP Shoppers Guide	Delete
1	Edit	CPS-500	Newborn Medical Report for Voluntary Termination of Parental Rights	Delete
1	Edit	CPS-506	Foster/Adoptive Parent Health Report	Delete
1	Edit	MS 02	Provider Selection Rack Card	Delete
1	Edit	MS 26	BabyReady Poster	Delete
1	Edit	CPS 07	Independent Living Program Education and Training Voucher Brochure	Delete
1	Edit	SE-431A	Child Support Payment Authorization Form	Delete
1	Edit	PA-108	Prior Authorization Form: Incontinence Supply All Waivers	Delete
1	Edit	EA-208	Authorization to Furnish / Release Information	Delete
1	Edit	SE-415	Petition for Modification Form	Delete
1	Edit	CPS 22	Foster Care Handbook	Delete
1	Edit	SE-431A	Child Support Payment Authorization Form	Delete