Hawaii Department of Human Services Forms

This form is used for applying for a license to operate a group child care center or group child care home in Hawaii.

This form is used for providing a statement of legal authority in the state of Hawaii. It is typically utilized in legal proceedings or administrative matters to establish the jurisdiction of a government agency or authority.

This form is used for listing the staff and volunteers working at a child care center in Hawaii.

This form is used for staff sequencing purposes in Hawaii.

This form is used for self-certification of child care licensing in the state of Hawaii. It is necessary for individuals or organizations operating child care facilities to complete and submit this form to comply with licensing requirements.

This Form is used for applying for a Certificate of Approval for Family Child Care in Hawaii.

This form is used as a supplement to the FCC application specifically for Hawaii. It includes additional information or requirements that are specific to the state of Hawaii.

This Form is used for giving consent and authorization to disclose confidential information to all household members in the state of Hawaii.

This form is used for individuals in Hawaii who wish to act as an authorized representative for someone else in immigration matters.

This Form is used for individuals in Hawaii who wish to act as an authorized representative. It provides instructions on how to complete the DHS1121A Agreement to Act as an Authorized Representative form.

This Form is used for applying for health coverage and financial assistance in Hawaii. It provides instructions on how to complete the DHS1100 Application accurately.

This Form is used for renewing medical assistance for Magi-Excepted Households in Hawaii. It provides instructions for completing the renewal form DHS1100B-2.

This Form is used for reporting self-employment earnings in the state of Hawaii. It provides instructions for completing Form DHS1109.

This Form is used for applying for health coverage and financial assistance in Hawaii.

This Form is used for applying for health coverage and assistance with cost payments in Hawaii.

This Form is used for applying for child care services in Hawaii.

This Form is used for applying for financial and SNAP (Supplemental Nutrition Assistance Program) assistance in the state of Hawaii. It is used to determine eligibility and facilitate the process of receiving financial support and assistance with food expenses.

This form is used for obtaining consent to release confidential information in Hawaii.

This form is used for designating or revoking an authorized representative in Hawaii.

This Form is used for renewing medical assistance for Magi-Excepted Households in Hawaii. It provides instructions on how to complete the renewal form (Form 1100B-2) for ongoing medical assistance eligibility.

This form is used for offering or accepting free interpreter services or waiving the need for them. It is specific to Hawaii.

This document provides information about 340B providers in Hawaii. It contains details about the healthcare organizations and entities that participate in the 340B drug pricing program in Hawaii.

This document is an appendix that contains the Quest Integration Evaluation Tool used in Hawaii. It is used for assessing the integration of various systems and processes in the state.