Minnesota Department of Human Services Forms

This Form is used for recording staff in-service training in the state of Minnesota. Keep track of training completed by staff members for compliance purposes.

This form is used for creating an emergency plan for child care facilities in Minnesota. It helps ensure that childcare centers are prepared for various emergencies and have a plan in place to keep children safe.

This document provides a summary of personnel information for a licensed child care center in Minnesota. It contains non-public information about the staff working at the center.

This Form is used for gathering personnel information in the state of Minnesota.

This Form is used for creating an Emergency Plan for Child Care in Minnesota. It helps child care providers prepare for and respond to emergencies to ensure the safety of children.

This document is used to create a personalized plan for professional growth and development in the state of Minnesota. It outlines specific goals, strategies, and resources to enhance one's skills and knowledge in their chosen field.

This form is used for parents in Minnesota to provide a statement about their infant rolling over when they are less than six months old.

This form is used for obtaining consent from parents or legal guardians to swaddle an infant in the state of Minnesota.

This form is used for reporting cases of maltreatment of minors in the state of Minnesota. It is mandated to be filled out by individuals who are required to report such incidents.

This form is used for submitting a variance request in Minnesota. It is related to regulations enforced by the Department of Homeland Security (DHS).

This form is used for mandated reporting of maltreatment of vulnerable adults in Minnesota. It is designed to gather information about suspected abuse, neglect, or financial exploitation of adults who are unable to protect themselves.

This type of document is a sample letter that the CEO or another representative in an organization in Minnesota would send to employees. It could be used to communicate important updates, announcements, or instructions.

This Form is used for enrolling in Special Needs Basiccare (SNBC) in Minnesota.

This document is a cover letter used to submit verification documentation in the state of Minnesota.

This Form is used for granting consent for a background study in Minnesota. It allows the organization to conduct the necessary checks on an individual's background for employment or volunteer purposes.

This document is for authorized contacts of agencies in Minnesota. It provides information on individuals who have been granted the authority to represent their agency.

This form is used for assessing assets in order to determine eligibility for Medical Assistance for Long-Term Care Services in Minnesota.

This Form is used for obtaining permission to use a wading pool in the state of Minnesota.

This type of document is a Spanish version of the DHS-3159 form used in Minnesota for voluntary acknowledgment of paternity.

This Form is used for voluntarily recognizing parentage and stating non-parentage of a spouse in Minnesota. This form is available in Somali language.

This form is used for voluntary recognition of parentage in Minnesota for individuals of Hmong ethnicity. It helps establish legal parental rights and responsibilities.

This document is a Home Safety Checklist specifically designed for residents of Minnesota. It helps ensure that your home is safe by identifying potential hazards and providing guidance on how to address them. Use this checklist to make sure your home is a secure and safe environment for you and your family.

This Form is used for authorizing the release of employment information in Minnesota.

This form is used for referring individuals in the Refugee Cash Assistance Program in Minnesota to employment services.

This form is used for calculating overpayment of Refugee Cash Assistance (RCA) in the state of Minnesota.

This form is used for Rule 25 assessments in Minnesota. It is used to evaluate an individual's eligibility for substance abuse treatment services.

This form is used for renewing Minnesota Health Care Programs in the state of Minnesota. It is specifically designed for Somali-speaking individuals.

This form is used for giving consent to release information from the Minnesota State-Wide Database of Substantiated Abuse/Neglect in Minnesota.

This document outlines the abuse prevention plan for the Adult Foster Care (AFC) and Community Residential Setting (CRS) program in Minnesota. It ensures the safety and well-being of individuals in these settings.

This form is used to request the closure of a support case in the state of Minnesota.

This form is used for filing a financial statement in Minnesota. It is used to provide information about one's financial condition and assets.

This document is used for voluntarily recognizing parentage and stating that the spouse is not the biological parent in Minnesota.

This form is used for Mcos - Minnesota to provide an assurance statement regarding the Deficit Reduction Act (DRA).

This form is used for enrolling as a third-party administrator in Minnesota.

This form is used for requesting fax services related to the Personal Care Attendant (PCA) program in Minnesota.