Minnesota Department of Human Services Forms

This form is used for collecting background and health history information for all children in out-of-home care in Minnesota.

This Form is used for conducting a post-placement assessment and reporting it to the court in Minnesota.

This form is used for reporting the details of an adoptive placement in the state of Minnesota.

This Form is used for the Consent of Parent to Adoption in the state of Minnesota. It also includes a waiver of notice for adoption hearings and proceedings. This document is executed before a judicial officer.

This form is used for filing a direct dispute or claim related to credit reporting in the state of Minnesota.

This form is used for requesting an exception to direct deposit of child support payments in Minnesota.

This form is used for authorizing automatic recurring withdrawals in Minnesota.

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 assessing the difficulty of care for children in pre-northstar care in Minnesota.

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 a voluntary out-of-home placement agreement for a non-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 document is used to notify recipients in Minnesota of non-covered services or items.

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 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 authorizing the use of a medical bed in Minnesota.

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 Pca Time and Activity Documentation in Minnesota.

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