South Dakota Department of Social Services Forms

This form is used for Medicaid managed care providers in South Dakota.

This form is used for reporting the medical information of newborn babies in South Dakota. It is required by the state for record-keeping and to ensure the well-being of the newborn.

This document acknowledges the receipt of information regarding a Hysterectomy procedure in South Dakota.

This form is used for obtaining consent for Medicaid sterilization procedures in South Dakota. It ensures that patients understand the risks and benefits of the procedure before it is performed.

This form is used for making an oral or written request for an administrative hearing in South Dakota.

This Form is used for reporting health information in South Dakota.

This document is a Provider Agreement for healthcare providers in South Dakota to participate in the Title XIX Non-emergency Medical Transportation Program.

This Form is used for declaring prior criminal convictions and military history in South Dakota.

This form is used for notifying the Estate Recovery Program in South Dakota about the death of an individual.

This Form is used for reporting welfare fraud in South Dakota. It helps gather information and evidence to investigate and address cases of fraudulent activity in welfare programs.

This Form is used for submitting a casualty referral in South Dakota.

This form is used for exiting the Supplemental Nutrition Assistance Program (SNAP) in South Dakota.

This form is used for exiting a Snap Group Home program in South Dakota.

This document is for clients in South Dakota who receive Supplemental Nutrition Assistance Program (SNAP) benefits and need to authorize debit for repayment of overissuance.

This document is an application for the South Dakota Weatherization Assistance program, which helps low-income individuals and families in South Dakota make their homes more energy-efficient.

This form is used for applying for accreditation for substance abuse programs in South Dakota.

This type of document is used for applying for an initial career lattice program in South Dakota.

This form is used for renewing a career lattice in South Dakota. It allows individuals to continue their professional development and advancement by renewing their qualifications and skills.

This Form is used for requesting an exemption from electronic payment requirements in South Dakota.

This Form is used for requesting payment for child care services in South Dakota.

This form is used for requesting mileage reimbursement from a health care provider in South Dakota.

This Form is used for individuals or entities in South Dakota to request designation as a Tribal Agent.

This document is used for requesting a change of address for a designated tribal agent in South Dakota.

This form is used by South Dakota to obtain permission to screen individuals for reports of abuse or neglect. It is an important step in ensuring the safety and well-being of vulnerable populations.

This Form is used for references in foster care, adoption, and kinship care in South Dakota.

This document is used for verifying foster parent training and self-instruction in South Dakota.

This document is used for assessing the initial mental health outcomes of individuals in South Dakota.

This document is used for measuring and evaluating the outcome of adult mental health services in South Dakota. It helps track the progress and effectiveness of mental health treatments for adults in the state.

This document is an outcome tool used in South Dakota to update and assess adult substance use disorder.

This form is used for assessing the mental health outcomes of patients upon their discharge in South Dakota. It helps to monitor and track the progress and effectiveness of mental health treatment.

This document is for conducting an initial interview to assess the outcome of family mental health in South Dakota. It is used as a tool to measure the mental health status of families in the state.