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	-	To Order Let’s Be Clear Materials	Delete
1	Edit	SE-415	Petition for Modification Form	Delete
1	Edit	CPS-522	Request for Payment	Delete
1	Edit	OLA 03	Office of Licensing and Accreditation Brochure	Delete
1	Edit	CPS 20	Foster Care Realities	Delete
1	Edit	RE 04	Medicaid Liens Brochure	Delete
1	Edit	MS-146	Sterilization Consent Form	Delete
1	Edit	CPS 20	Foster Care Realities	Delete
1	Edit	DSS 08	Notice of Privacy Brochure	Delete
1	Edit	DCS 06	Voluntary Paternity Establishment Handbook and Form	Delete
1	Edit	CPS 05	Positive Indian Parenting Brochure	Delete
1	Edit	MS-100	Recipient Forms: HIPAA Privacy Consent Form	Delete
1	Edit	-	To Order Let’s Be Clear Materials	Delete
1	Edit	CPS-522	Request for Payment	Delete
1	Edit	BH 24	Behavioral Health Resources Flyer	Delete
1	Edit	RE 04	Medicaid Liens Brochure	Delete
1	Edit	CPS 20	Foster Care Realities	Delete
1	Edit	CPS 07	Independent Living Program Education and Training Voucher Brochure	Delete
1	Edit	-	To Order Let’s Be Clear Materials	Delete
1	Edit	EAFSSA	Children and Family Medical Assistance Application	Delete
1	Edit	RE 04	Medicaid Liens Brochure	Delete
1	Edit	EA 23	CHIP Poster	Delete
1	Edit	-	To Order Let’s Be Clear Materials	Delete
1	Edit	CPS 20	Foster Care Realities	Delete
1	Edit	CPS	Provider Mileage Request	Delete
1	Edit	SE-431A	Child Support Payment Authorization Form	Delete
1	Edit	RE 04	Medicaid Liens Brochure	Delete
1	Edit	CPS 05	Positive Indian Parenting Brochure	Delete
1	Edit	CPS 22	Foster Care Handbook	Delete
1	Edit	BH 24	Behavioral Health Resources Flyer	Delete
1	Edit	CPS-522	Request for Payment	Delete
1	Edit	CPS-565	Foster Parent Training & Self-Instruction	Delete
1	Edit	BH 15	Criminal Justice Initiative Flyer	Delete
1	Edit	MS 02	Provider Selection Rack Card	Delete
1	Edit	CPS 05	Positive Indian Parenting Brochure	Delete
1	Edit	PA-103	Prior Authorization Forms: Synagis	Delete
1	Edit	EA 09	SNAP Shoppers Guide	Delete
1	Edit	-	To Order Let’s Be Clear Materials	Delete
1	Edit	CPS-522	Request for Payment	Delete
1	Edit	BH 24	Behavioral Health Resources Flyer	Delete
1	Edit	CPS-533	Adoption Registry Form	Delete
1	Edit	EA 23	CHIP Poster	Delete
1	Edit	PA-103	Prior Authorization Forms: Synagis	Delete
1	Edit	CPS 20	Foster Care Realities	Delete
1	Edit	MS 26	BabyReady Poster	Delete
1	Edit	OLA-103	Child Care Declaration of Prior Criminal Conviction and Military History	Delete
1	Edit	RE 04	Medicaid Liens Brochure	Delete
1	Edit	ORFI-831	Estate Recovery Notification of Death Form	Delete
1	Edit	PA-108	Prior Authorization Form: Incontinence Supply All Waivers	Delete
1	Edit	CPS-565	Foster Parent Training & Self-Instruction	Delete
1	Edit	EA 23	CHIP Poster	Delete
1	Edit	CPS 05	Positive Indian Parenting Brochure	Delete
1	Edit	NEMT-964	Non-Emergency Medical Travel (NEMT) HIPAA Authorization	Delete
1	Edit	SE-415	Petition for Modification Form	Delete
1	Edit	PA-103	Prior Authorization Forms: Synagis	Delete
1	Edit	MS-100	Recipient Forms: HIPAA Privacy Consent Form	Delete
1	Edit	CPS-522	Request for Payment	Delete
1	Edit	EA 09	SNAP Shoppers Guide	Delete
1	Edit	MS 26	BabyReady Poster	Delete
1	Edit	PA-103	Prior Authorization Forms: Synagis	Delete
1	Edit	BH 24	Behavioral Health Resources Flyer	Delete
1	Edit	CPS-533	Adoption Registry Form	Delete
1	Edit	PA-103	Prior Authorization Forms: Synagis	Delete
1	Edit	EA-301	Economic Assistance Application	Delete
1	Edit	MS-146	Sterilization Consent Form	Delete
1	Edit	DSS 08	Notice of Privacy Brochure	Delete
1	Edit	OLA-103	Child Care Declaration of Prior Criminal Conviction and Military History	Delete
1	Edit	DCS 06	Voluntary Paternity Establishment Handbook and Form	Delete
1	Edit	ORFI-831	Estate Recovery Notification of Death Form	Delete
1	Edit	MS-100	Recipient Forms: HIPAA Privacy Consent Form	Delete