The Department of Social Services has free forms and publications that can provide you with information and guidance in a number of important areas.

This page can help you find the information you need in the following ways:

		Some forms are available to fill out and submit online. The remaining online forms can be filled out on your computer, printed and mailed.
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Note: Some documents are PDF files and require Adobe Acrobat to open them. If you don’t have Adobe Acrobat, click here to download the latest version.

Abuse and Neglect

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
CPS 04	Mandatory Reporting Brochure	n/a	n/a
CPS 11	Central Registry Brochure	n/a	n/a
CPS-504	Present Danger Plan	n/a		n/a
CPS-593	Permission to Screen for Reports of Abuse and Neglect	n/a			n/a	n/a
CPS-594	Declaration of Prior Criminal Conviction and Military History	n/a		n/a	n/a	n/a

Administrative Hearings

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
DSS 03	Administrative Hearings Brochure		n/a	n/a

Adoption and Foster Care

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
CPS 09	Adoption Subsidy Program	n/a	n/a	n/a
CPS 19	Foster Care Brochure	n/a	n/a	n/a
CPS 19N	Foster Care Brochure (Native American Theme)	n/a	n/a	n/a
CPS 20	Foster Care Realities	n/a	n/a	n/a
CPS 20N	Foster Care Realities (Native American Theme)	n/a	n/a	n/a
CPS 21	Foster Care Myths & Facts	n/a	n/a	n/a
CPS 21N	Foster Care Myths & Facts (Native American Theme)	n/a	n/a	n/a
CPS 22	Foster Care Handbook	n/a		n/a	n/a	n/a
CPS-523	Request for Reimbursement of Adoption Home Study Form	n/a		n/a	n/a	n/a

Behavioral Health

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
-	To Order Notes to Self Materials		n/a	n/a	n/a	n/a
-	To Order Suicide Prevention Materials		n/a	n/a	n/a	n/a
-	To Order Let’s Be Clear Materials		n/a	n/a
BH 04	Substance Use Disorder Involuntary Commitment Process	n/a	n/a	n/a
BH 05	Intensive Methamphetamine Treatment Services	n/a	n/a	n/a
BH 11	Supported Housing Flyer	n/a	n/a	n/a
BH 13	Juvenile Justice Reinvestment Initiative Flyer	n/a	n/a	n/a
BH 14	Substance Use Prevention Services Flyer	n/a	n/a	n/a
BH 15	Criminal Justice Initiative Flyer	n/a		n/a	n/a	n/a
BH 16	Pregnancy Alcohol Flyer	n/a	n/a	n/a
BH 24	Behavioral Health Resources Flyer	n/a	n/a	n/a
BH 26	Working in Behavioral Health	n/a		n/a

Child Care Services

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
CCS 06	Child Care Assistance Program Brochure	n/a	n/a
CCS 09	SD Child Safety Seat Brochure	n/a	n/a
CCS 10	SD Child Development Associate Training Program	n/a	n/a	n/a
CCS 14	Choosing Child Care Handbook	n/a	n/a
OLA 03	Office of Licensing and Accreditation Brochure	n/a	n/a	n/a
OLA-102	Application for Admission to Child Care	n/a		n/a	n/a	n/a
OLA-104	Daily Attendance Form	n/a		n/a	n/a	n/a
OLA-105	Child Care Provider Training Record	n/a		n/a	n/a	n/a
OLA-106	Immunization Affidavit	n/a		n/a	n/a	n/a
OLA-107	Medication Administration Form	n/a		n/a	n/a	n/a
OLA-108	Parent Agreement	n/a		n/a	n/a	n/a
OLA-109	Serious Incident Report Form	n/a		n/a	n/a	n/a
OLA-110	Child Care Provider Form	n/a		n/a	n/a	n/a
OLA-111	Emergency Preparedness Drill Log	n/a		n/a	n/a	n/a
OLA-112	Procedures for Identifying CA/N	n/a		n/a	n/a	n/a
OLA-113	Sample Emergency Preparedness Plan	n/a		n/a	n/a	n/a
OLA-114	Licensed School Age Care Programs Located in a School - Floor Plan Review	n/a		n/a	n/a	n/a
OLA-116	Floor Plan Review Process and Program Proposal	n/a		n/a	n/a	n/a
OLA-118	Written Care Plan for a Child with Allergies	n/a		n/a	n/a	n/a

Child Protection Services

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
CPS 01	Child Protection Services Booklet	n/a	n/a
CPS 03	Safe Havens Brochure	n/a	n/a	n/a
CPS 07	Independent Living Program Education and Training Voucher Brochure	n/a	n/a
CPS 10	Independent Living Program Brochure	n/a	n/a
CPS 13	Young Voices Brochure	n/a	n/a	n/a
CPS 14	Young Voices Handbook	n/a	n/a	n/a
CPS 23	Safe Havens Poster	n/a	n/a	n/a

Child Support

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
DCS 01	Child Support Modification Handbook	n/a	n/a	n/a
DCS 02	A Guide for Teenage Parents Brochure	n/a		n/a	n/a	n/a
DCS 03	Income & Wage Withholding Brochure	n/a	n/a	n/a
DCS 04	National Medical Support Notice Brochure	n/a	n/a	n/a
DCS 05	Payment Options Brochure	n/a	n/a	n/a
DCS 06	Voluntary Paternity Establishment Handbook and Form	n/a	n/a
DCS 08	Child Support Parent Handbook	n/a	n/a	n/a

General

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
-	South Dakota Weatherization Field Guide	n/a		n/a	n/a	n/a
EA 11	Weatherization Assistance Brochure	n/a	n/a
EA 12	Energy Assistance Brochure	n/a	n/a

General Social Service Documents

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
DSS 06	Discrimination Complaint Brochure	n/a	n/a	n/a
DSS 07	Discrimination Complaint Poster	n/a	n/a	n/a
DSS 08	Notice of Privacy Brochure	n/a	n/a
DSS 09	DSS Handbook	n/a	n/a	n/a
EA 15	Emergency Services for SD Flyer	n/a	n/a	n/a
EA 18	Long-Term Care Partnership Brochure	n/a	n/a	n/a
EA 19	Guide to Assistance Handbook	n/a	n/a

Medical Eligibility

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
EA 05	Medicare Savings Program Brochure	n/a	n/a
EA 08	Medicaid Spousal Care Handbook	n/a	n/a	n/a
EA 14	CHIP Rack Card	n/a	n/a
EA 16	Medical Assistance for Children and Families: IHS Specific	n/a	n/a	n/a
EA 23	CHIP Poster	n/a	n/a	n/a
EA-211	Authorization to Release Information	n/a			n/a	n/a
EA-340	Psychiatric Residential Treatment Facility Referral Form	n/a		n/a	n/a	n/a
MS 01	Medical Assistance Program Recipient Handbook	n/a	n/a	n/a

Medical Services

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
MS 01	Medical Assistance Program Recipient Handbook	n/a	n/a	n/a
MS 02	Provider Selection Rack Card	n/a	n/a	n/a
MS 03	Well-Child Care Brochure	n/a	n/a
MS 04	Medicaid Non-Emergency Medical Travel Brochure	n/a	n/a	n/a
MS 05	Well Visit Rack Card	n/a	n/a	n/a
MS 06	Health Home Brochure	n/a	n/a	n/a
MS 07	Premium Assistance Rack Card	n/a	n/a
MS 08	Constituent Liaison Services Brochure	n/a	n/a	n/a
MS 10	Medicaid Pregnancy Handbook	n/a	n/a	n/a
MS 12	Well Child Poster	n/a	n/a	n/a
MS 13	Behavioral Health Resources	n/a	n/a	n/a
MS 15	Well Visit Poster	n/a	n/a	n/a
MS 18	Constituent Liaison Services Poster	n/a	n/a	n/a
MS 25	BabyReady Rackcard	n/a	n/a	n/a
MS 26	BabyReady Poster	n/a	n/a	n/a
MS 28	BabyReady Flyer	n/a		n/a	n/a	n/a
MS-101	Advanced Recipient Notice of Non-Coverage	n/a		n/a	n/a	n/a
MS-112	Primary Care Provider Program Reminders - Emergency Room	n/a		n/a	n/a	n/a
MS-121	Hospice Notification	n/a		n/a	n/a	n/a
MS-129	Medicaid Attestation Form on the Appropriateness of the Qualified Clinical Trials	n/a		n/a	n/a	n/a
MS-130	Preadmission Screening and Resident Review (PASRR) Screening Form	n/a		n/a	n/a	n/a
MS-131	Preadmission Hospital Exemption Form	n/a		n/a	n/a	n/a
MS-132	ID/DD Level II Evaluation Form	n/a		n/a	n/a	n/a
MS-133	BabyReady Program Addendum	n/a		n/a	n/a	n/a
MS-134	BabyReady Program Application	n/a		n/a	n/a	n/a
MS-135	BabyReady Program Barriers to Care Initiatives	n/a		n/a	n/a	n/a
MS-136	BabyReady Program Overview	n/a		n/a	n/a	n/a
MS-137	BabyReady Program Opt-In & Selection Form	n/a		n/a	n/a	n/a
MS-138	Barriers to Care Initiative Annual Reporting Form	n/a		n/a	n/a	n/a
MS-139	BabyReady Exit Form	n/a		n/a	n/a	n/a
MS-147	School Based Medicaid Program Time Study Implementation Plan	n/a		n/a	n/a	n/a
NEMT-953	NEMT Primary Care Provider/Health Home Provider Questionnaire	n/a		n/a	n/a	n/a
NEMT-964	Non-Emergency Medical Travel (NEMT) HIPAA Authorization	n/a		n/a	n/a	n/a
NEMT-970	NEMT Reimbursement Form | Day Trip	n/a		n/a	n/a	n/a
NEMT-971	NEMT Reimbursement Form | Overnight Trip	n/a		n/a	n/a	n/a
NEMT-972	NEMT Additional Lodging	n/a		n/a	n/a	n/a
NEMT-973	NEMT Appointment Verification Form	n/a		n/a	n/a	n/a
PA-112	Prior Authorization Form: Long Term Acute Care and Out-of-State Rehab	n/a		n/a	n/a	n/a
PA-113	Prior Authorization Form: Medical Nutrition	n/a		n/a	n/a	n/a
PA-114	Prior Authorization Form: Temporary Exemption to Allow Family Members to Provide PDN	n/a		n/a	n/a	n/a

Parent Education

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
CPS 02	Common Sense Parenting Brochure	n/a	n/a
CPS 05	Positive Indian Parenting Brochure	n/a	n/a	n/a
CPS 15	Positive Indian Parenting Flyer	n/a	n/a	n/a

Recoveries and Fraud

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
RE 03	Estate Recovery Program Brochure	n/a	n/a	n/a
RE 04	Medicaid Liens Brochure	n/a	n/a	n/a

South Dakota EBT

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
EBT 01	EBT Client Handbook	n/a	n/a

Temporary Assistance for Needy Families

Doc #	Document Name	Instructions	Online Version	Spanish Version	English Version	Add to Cart
CC-975	TANF Child Care Benefits Application	n/a	n/a	n/a
EA 04	TANF Brochure	n/a		n/a	n/a	n/a