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235709

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This form is used for voluntarily acknowledging parentage in the state of Minnesota. It allows individuals to legally establish parent-child relationships.

This form is used for Minnesota residents who want to voluntarily establish parentage for a child. It includes a statement from the spouse stating that they are not the biological parent of the child.

This Form is used for applying for Support and Collections Services in Minnesota for Somali-speaking individuals.

This form is used for consenting to a voluntary out-of-home placement agreement for an Indian child in Minnesota.

This Form is used for applying for the Title IV-E Foster Care Supplement to the Health Care Programs in Minnesota.

This Form is used for requesting good cause exemption for the Minnesota Energy Assistance Program.

This form is used for notifying members in Minnesota about noncovered prescriptions in advance.

This form is used for employment services in the state of Minnesota. It is a worksheet for individuals seeking assistance from the Department of Homeland Security.

This Form is used for completing a Pca assessment and creating a service plan for individuals in Minnesota. It helps in determining the level of assistance an individual needs and creating a plan for their personal care assistance services.

This form is used for CDC's Community Support Plan which is compliant with Rule 185 in Minnesota. It helps in providing support to the community.

This document is a helpful checklist for selecting a nursing home for yourself or a loved one. It outlines key factors to consider, such as staff qualifications, facility cleanliness, and resident safety measures.

This form is used for submitting a summary of your move plan in Minnesota.

This document is for creating a plan to support individuals transitioning to positive and supported living arrangements in Minnesota.

This form is used for tracking hospital staff who have passed the DHS Hospital Presumptive Eligibility Online Training Course in Minnesota.

This form is used for referring individuals in Minnesota for reassessment for PCA (Personal Care Assistance) services.

This form is used for applying for a hardship waiver in Minnesota for HCN (Health Care Worker in a Critical Industry) workers.

This form is used for certifying and creating a plan of care for home health services in Minnesota.

This form is used for requesting technical changes in the home care program in Minnesota.

This form is used for submitting a technical change request for Personal Care Assistance (PCA) in Minnesota.

This form is used for conducting a review and providing criteria for limiting the quantity of Seroquel medication in Minnesota.

This form is used for obtaining authorization for the use of immunomodulator drugs in Minnesota.

This form is used for the Adult Day Treatment Contract Cover Sheet in Minnesota. It is used to provide information regarding the contract for adult day treatment services.

This form is used for applying to become an Adult Rehabilitative Health Services (ARMHS) provider in Minnesota.

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