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Forms and Publications

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:

  Order Online 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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Service Area:

Abuse and Neglect

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
CPS 04Mandatory Reporting Brochuren/an/aspanish versionenglish versionadd to cart
CPS 11Central Registry Brochuren/an/aspanish versionenglish versionadd to cart
CPS-504Present Danger Plann/aonline versionn/aenglish versionadd to cart
CPS-593Permission to Screen for Reports of Abuse and Neglectn/aonline versionspanish versionn/an/a
CPS-594Declaration of Prior Criminal Conviction and Military Historyn/aonline versionn/an/an/a

Administrative Hearings

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
DSS 03Administrative Hearings Brochureinstructionsn/an/aenglish versionadd to cart

Adoption and Foster Care

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
CPS 09Adoption Subsidy Program n/an/an/aenglish versionadd to cart
CPS 19Foster Care Brochuren/an/an/aenglish versionadd to cart
CPS 19NFoster Care Brochure (Native American Theme)n/an/an/aenglish versionadd to cart
CPS 20Foster Care Realitiesn/an/an/aenglish versionadd to cart
CPS 20NFoster Care Realities (Native American Theme)n/an/an/aenglish versionadd to cart
CPS 21Foster Care Myths & Factsn/an/an/aenglish versionadd to cart
CPS 21NFoster Care Myths & Facts (Native American Theme)n/an/an/aenglish versionadd to cart
CPS 22Foster Care Handbookn/aonline versionn/an/an/a
CPS-523Request for Reimbursement of Adoption Home Study Formn/aonline versionn/an/an/a

Behavioral Health

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
-To Order Notes to Self Materialsinstructionsn/an/an/an/a
-To Order Suicide Prevention Materialsinstructionsn/an/an/an/a
-To Order Avoid Opiod Materialsinstructionsn/an/an/an/a
BH 04Substance Use Disorder Involuntary Commitment Processn/an/an/aenglish versionadd to cart
BH 05Intensive Methamphetamine Treatment Servicesn/an/an/aenglish versionadd to cart
BH 11Supported Housing Flyern/an/an/aenglish versionadd to cart
BH 13Juvenile Justice Reinvestment Initiative Flyern/an/an/aenglish versionadd to cart
BH 14Substance Use Prevention Services Flyern/an/an/aenglish versionadd to cart
BH 15Criminal Justice Initiative Flyern/an/an/aenglish versionadd to cart
BH 16Pregnancy Alcohol Flyern/an/an/aenglish versionadd to cart
BHAO01AVOID OPIOID - How to Use Naloxone Brochuren/an/an/aenglish versionadd to cart
BHAO09AVOID OPIOID - Care Coordination Brochuren/an/an/aenglish versionadd to cart
BHAO13AVOID OPIOID - Statewide Drop-Off Site Postcardsn/an/an/aenglish versionadd to cart
BHAO14AVOID OPIOID - Resource Guiden/an/an/aenglish versionadd to cart

Child Care Services

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
CCS 06Child Care Assistance Program Brochuren/an/aspanish versionenglish versionadd to cart
CCS 09SD Child Safety Seat Brochuren/an/aspanish versionenglish versionadd to cart
CCS 10SD Child Development Associate Training Programn/an/an/aenglish versionadd to cart
CCS 14Choosing Child Care Handbookn/an/aspanish versionenglish versionadd to cart
OLA 03Office of Licensing and Accreditation Brochuren/an/an/aenglish versionadd to cart
OLA-102Application for Admission to Child Caren/aonline versionn/an/an/a
OLA-104Daily Attendance Form n/aonline versionn/an/an/a
OLA-105Child Care Provider Training Recordn/aonline versionn/an/an/a
OLA-106Immunization Affidavitn/aonline versionn/an/an/a
OLA-107Medication Administration Formn/aonline versionn/an/an/a
OLA-108Parent Agreementn/aonline versionn/an/an/a
OLA-109Serious Incident Report Formn/aonline versionn/an/an/a
OLA-110Child Care Provider Formn/aonline versionn/an/an/a
OLA-111Emergency Preparedness Drill Logn/aonline versionn/an/an/a
OLA-112Procedures for Identifying CA/N n/aonline versionn/an/an/a
OLA-113Sample Emergency Preparedness Plann/aonline versionn/an/an/a
OLA-114Licensed School Age Care Programs Located in a School - Floor Plan Reviewn/aonline versionn/an/an/a
OLA-116Floor Plan Review Process and Program Proposaln/aonline versionn/an/an/a
OLA-118Written Care Plan for a Child with Allergiesn/aonline versionn/an/an/a

Child Protection Services

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
CPS 01Child Protection Services Bookletn/an/aspanish versionenglish versionadd to cart
CPS 03Safe Havens Brochuren/an/an/aenglish versionadd to cart
CPS 07Independent Living Program Education and Training Voucher Brochuren/an/aspanish versionenglish versionadd to cart
CPS 10Independent Living Program Brochuren/an/aspanish versionenglish versionadd to cart
CPS 13Young Voices Brochuren/an/an/aenglish versionadd to cart
CPS 14Young Voices Handbookn/an/an/aenglish versionadd to cart
CPS 23Safe Havens Postern/an/an/aenglish versionadd to cart

Child Support

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
DCS 01Child Support Modification Handbookn/an/an/aenglish versionadd to cart
DCS 02A Guide for Teenage Parents Brochuren/aonline versionn/an/an/a
DCS 03Income & Wage Withholding Brochuren/an/an/aenglish versionadd to cart
DCS 04National Medical Support Notice Brochuren/an/an/aenglish versionadd to cart
DCS 05Payment Options Brochuren/an/an/aenglish versionadd to cart
DCS 06Voluntary Paternity Establishment Handbook and Formn/an/aspanish versionenglish versionadd to cart
DCS 08Child Support Parent Handbookn/an/an/aenglish versionadd to cart

General

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
-South Dakota Weatherization Field Guiden/aonline versionn/an/an/a
EA 11Weatherization Assistance Brochuren/an/aspanish versionenglish versionadd to cart
EA 12Energy Assistance Brochuren/an/aspanish versionenglish versionadd to cart

General Social Service Documents

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
DSS 06Discrimination Complaint Brochuren/an/an/aenglish versionadd to cart
DSS 07Discrimination Complaint Postern/an/an/aenglish versionadd to cart
DSS 08Notice of Privacy Brochuren/an/aspanish versionenglish versionadd to cart
DSS 09DSS Handbookn/an/an/aenglish versionadd to cart
EA 15Emergency Services for SD Flyern/an/an/aenglish versionadd to cart
EA 18Long-Term Care Partnership Brochuren/an/an/aenglish versionadd to cart
EA 19Guide to Assistance Handbookn/an/aspanish versionenglish versionadd to cart

Medical Eligibility

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
EA 05Medicare Savings Program Brochuren/an/aspanish versionenglish versionadd to cart
EA 08Medicaid Spousal Care Handbookn/an/an/aenglish versionadd to cart
EA 14CHIP Rack Cardn/an/aspanish versionenglish versionadd to cart
EA 16Medical Assistance for Children and Families: IHS Specificn/an/an/aenglish versionadd to cart
EA 23CHIP Postern/an/an/aenglish versionadd to cart
EA-211Authorization to Release Informationn/aonline versionspanish versionn/an/a
EA-340Psychiatric Residential Treatment Facility Referral Formn/aonline versionn/an/an/a
MS 01Medical Assistance Program Recipient Handbookn/an/aspanish versionenglish versionadd to cart

Medical Services

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
MS 01Medical Assistance Program Recipient Handbookn/an/aspanish versionenglish versionadd to cart
MS 02Provider Selection Rack Cardn/an/an/aenglish versionadd to cart
MS 03Well-Child Care Brochuren/an/aspanish versionenglish versionadd to cart
MS 04Medicaid Non-Emergency Medical Travel Brochuren/an/an/aenglish versionadd to cart
MS 05Well Visit Rack Card n/an/an/aenglish versionadd to cart
MS 06Health Home Brochuren/an/an/aenglish versionadd to cart
MS 07Premium Assistance Rack Cardn/an/aspanish versionenglish versionadd to cart
MS 08Constituent Liaison Services Brochuren/an/an/aenglish versionadd to cart
MS 10Medicaid Pregnancy Handbookn/an/an/aenglish versionadd to cart
MS 12Well Child Postern/an/an/aenglish versionadd to cart
MS 13Behavioral Health Resourcesn/an/an/aenglish versionadd to cart
MS 15Well Visit Postern/an/an/aenglish versionadd to cart
MS 18Constituent Liaison Services Postern/an/an/aenglish versionadd to cart
MS 25BabyReady Rackcardn/an/an/aenglish versionadd to cart
MS 26BabyReady Postern/an/an/aenglish versionadd to cart
MS 28BabyReady Flyern/aonline versionn/an/an/a
MS-101Advanced Recipient Notice of Non-Coveragen/aonline versionn/an/an/a
MS-112Primary Care Provider Program Reminders - Emergency Roomn/aonline versionn/an/an/a
MS-121Hospice Notificationn/aonline versionn/an/an/a
MS-129Medicaid Attestation Form on the Appropriateness of the Qualified Clinical Trialsn/aonline versionn/an/an/a
MS-130Preadmission Screening and Resident Review (PASRR) Screening Formn/aonline versionn/an/an/a
MS-131Preadmission Hospital Exemption Formn/aonline versionn/an/an/a
MS-132ID/DD Level II Evaluation Formn/aonline versionn/an/an/a
MS-133BabyReady Program Addendumn/aonline versionn/an/an/a
MS-134BabyReady Program Applicationn/aonline versionn/an/an/a
MS-135BabyReady Program Barriers to Care Initiativesn/aonline versionn/an/an/a
MS-136BabyReady Program Overviewn/aonline versionn/an/an/a
MS-137BabyReady Program Opt-In & Selection Formn/aonline versionn/an/an/a
MS-138Barriers to Care Initiative Annual Reporting Formn/aonline versionn/an/an/a
MS-139BabyReady Exit Formn/aonline versionn/an/an/a
NEMT-953NEMT Primary Care Provider/Health Home Provider Questionnairen/aonline versionn/an/an/a
NEMT-964Non-Emergency Medical Travel (NEMT) HIPAA Authorizationn/aonline versionn/an/an/a
NEMT-970NEMT Reimbursement Form | Day Tripn/aonline versionn/an/an/a
NEMT-971NEMT Reimbursement Form | Overnight Tripn/aonline versionn/an/an/a
NEMT-972NEMT Additional Lodgingn/aonline versionn/an/an/a
NEMT-973NEMT Appointment Verification Formn/aonline versionn/an/an/a
PA-112Prior Authorization Form: Long Term Acute Care and Out-of-State Rehabn/aonline versionn/an/an/a
PA-113Prior Authorization Form: Medical Nutritionn/aonline versionn/an/an/a

Parent Education

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
CPS 02Common Sense Parenting Brochuren/an/aspanish versionenglish versionadd to cart
CPS 05Positive Indian Parenting Brochuren/an/an/aenglish versionadd to cart
CPS 15Positive Indian Parenting Flyern/an/an/aenglish versionadd to cart

Recoveries and Fraud

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
RE 03Estate Recovery Program Brochuren/an/an/aenglish versionadd to cart
RE 04Medicaid Liens Brochuren/an/an/aenglish versionadd to cart

South Dakota EBT

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
EBT 01EBT Client Handbookn/an/aspanish versionenglish versionadd to cart

Temporary Assistance for Needy Families

Doc #Document NameInstructionsOnline VersionSpanish VersionEnglish VersionAdd to Cart
CC-975TANF Child Care Benefits Applicationn/an/an/aenglish versionadd to cart
EA 04TANF Brochuren/an/aspanish versionenglish versionadd to cart