Minnesota Department of Human Services Forms

This Form is used for completing the Air Ambulance Checklist required by the Minnesota Department of Human Services for the Medical Assistance Health Care Programs.

This form is used for applying for Hospital Presumptive Eligibility (HPE) in Minnesota. It allows individuals to apply for temporary health coverage while their full eligibility for Medicaid is determined.

This Form is used for obtaining authorization for the use of Synagis medication in the state of Minnesota for Medical Assistance or MinnesotaCare recipients.

This form is used for requesting budget revisions in Minnesota.

This Form is used for parents in Minnesota to acknowledge their choice of a legal non-licensed provider for their child.

This document provides information on the equipment and supplies needed for toddlers between the ages of 16 months and 32 months in Minnesota.

This training is required for individuals in Minnesota who are interested in starting a family child care business. It covers essential topics such as health and safety standards, child development, and business practices.

This Form is used for licensing requirements for family child care in the state of Minnesota.

This document is a checklist for required screenings for children in residential settings in Minnesota. It ensures that necessary screenings are conducted for the well-being of children in these settings.

This Form is used for conducting a Vulnerability Assessment and Sexual Abusive Behavior Screen for children living in residential settings in the state of Minnesota. It helps to identify potential risks and protect children from abuse.

This Form is used for pre-enrollment in Minnesota. It is a necessary step to begin the enrollment process for various educational institutions in the state.

This document is for applying for a license in the state of Minnesota.

This form is used for applying for Rule 29 Certification in the state of Minnesota. It is a document required to request certification for a particular legal matter.

This form is used for conducting a monthly inspection of crib safety in Minnesota to ensure the safety of infants.

This form is used for obtaining authorization to use a mobility device in Minnesota.

This form is used for applying for the Supplemental Nutrition Assistance Program (SNAP) specifically designed for seniors aged 60 and older in Minnesota.

This document for assessing family's child care needs in Minnesota.

This Form is used for applying for adoption and child foster care in Minnesota. It is specific to the state of Minnesota.

This form is used for obtaining permission to use a swimming pool in Minnesota.

This form is used to provide medical modification information in the state of Minnesota.

This document is a referral form used in Minnesota for support and collections cases by the Department of Homeland Security (DHS). It is used to refer individuals to the appropriate agencies for assistance with support and collection matters.

This form is used for setting up direct deposit for child support payments in Minnesota. It is available in Somali language.

This form is used for referring cases to support and collections services in Minnesota specifically for the Hmong community.

This form is used for referring individuals to support and collections services in Minnesota for individuals who speak Somali.

Este formulario se utiliza en Minnesota para reconocer o negar la paternidad voluntaria por parte de un esposo.

This form is used for authorizing the release of child support information to a third party in the state of Minnesota.

This document is used for voluntary recognition of parentage in Minnesota, specifically for Somali speakers. It is a form provided by the Department of Homeland Security (DHS) in Minnesota.

This form is used for revoking a spouse's non-parentage statement in Minnesota. It is specifically designed for use by the Hmong community in Minnesota.