North Dakota Department of Health and Human Services Forms

This type of document provides the concept of operations forms for minimum care facilities in North Dakota.

This document outlines the procedure for converting an ambulance into a bus and deploying it in North Dakota.

This document outlines the plan for operating reception centers in North Dakota. It provides details on how these centers will be managed and the procedures that will be followed.

This document provides information and guidance for the North Dakota staff on the staging orientation process. It covers important details and requirements to ensure a successful staging orientation.

This document outlines the management process for coordinating pre-hospital stabilization transfers in the Department Operation Center of North Dakota. It provides guidance and procedures for ensuring efficient and effective transfer of patients to appropriate medical facilities.

This form is used for rapidly triaging and transferring patients with potential communicable diseases in North Dakota.

This form is used for filing a complaint regarding the Long Term Care Ombudsman Program in North Dakota.

This document is a Roommate Authorization to Disclose Protected Health Information that grants permission for a roommate to access and share health information. It is specific to North Dakota and may be used in situations where electronic monitoring devices are involved.

This document is used for documenting electronic monitoring in the state of North Dakota. It provides guidelines and instructions on how to properly document the use of electronic monitoring devices for individuals under supervision.

This form is used for reporting suspected child abuse or neglect in North Dakota. It helps authorities collect information and take appropriate action to protect vulnerable children.

This form is used for requesting an appeal of the child abuse and neglect assessment decision in the state of North Dakota.

This form is used for keeping track of attendance for child care assistance in North Dakota.

This form is used for agreeing to provide respite care services under the Lifespan Respite Care Grant in North Dakota.

This form is used for recording the services provided by respite care providers under the Lifespan Respite Care Grant in North Dakota.

This Form is used for requesting gap funding in the state of North Dakota. Gap funding is financial assistance provided to bridge the gap between other sources of funding and the total cost of a project or initiative.

This document is a checklist for onboarding peer support specialists in North Dakota. It outlines the necessary steps and requirements for successfully bringing new peer support specialists on board in the state.

This form is used for applying to the Ryan White Part B Program in North Dakota.

This document is an application for becoming a provider of prevention services under Title IV-E in North Dakota.

This document is used for collecting data on the outcomes of child and family services provided through the IV-E Prevention Services program in North Dakota. It is a survey designed to assess the impact of these services on children and families.

This document is used for screening individuals in North Dakota who may be eligible for Title IV-E Prevention Services. It helps determine if they meet the criteria for receiving these services.

This form is used for applying for the Veterinarian Loan Repayment Program in North Dakota. It allows veterinarians to apply for loan repayment in exchange for practicing in a designated shortage area.

This form is used for appealing a Minimum Data Set (MDS) in North Dakota. It allows individuals to request a review of the MDS assessment and provide additional information for consideration.

This document is an agreement between an Emergency Medical Services (EMS) agency and a medical director in North Dakota. It outlines the responsibilities and expectations of the medical director in providing medical oversight and guidance to the EMS agency.

This document is an agreement for Squad Leaders in an EMS (Emergency Medical Services) agency in North Dakota. It outlines the roles and responsibilities of Squad Leaders within the agency.

This document is a report filed after an ambulance collision in North Dakota. It provides details and information regarding the incident.

This document provides a professional recommendation for an individual or business located in North Dakota. It highlights the skills, qualifications, and achievements of the applicant, and can be used for various purposes such as job applications, college admissions, or professional references.

This document provides recommendations for visiting and exploring North Dakota, including nature, attractions, and cultural activities.

This document is a personal statement for individuals applying for the Certified Peer Support Specialist I position in North Dakota.

This document is a personal statement for a Certified Peer Support Specialist II position in North Dakota. It details the individual's qualifications and experience in providing support and assistance to individuals with mental health conditions.

This document is used for verifying work or volunteer hours for Certified Peer Support Specialists in North Dakota.