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South Dakota Department of Social Services Forms

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Form DSS-CC-950 Child Care Assistance Application - South Dakota PDF DOCX

Form DSS-CC-950 Child Care Assistance Application - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Child Care Assistance
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Formulario DSS-CC-950 Solicitud De Asistencia Para Cuidado Infantil - South Dakota (Spanish) PDF DOCX

Formulario DSS-CC-950 Solicitud De Asistencia Para Cuidado Infantil - South Dakota (Spanish)
Legal United States Legal Forms South Dakota Legal Forms Cuidado Infantil
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Form OLA-107 Child Medication Permission and Administration Form - South Dakota PDF DOCX

Form OLA-107 Child Medication Permission and Administration Form - South Dakota
Legal United States Legal Forms Parental Consent Form Child Care Forms South Dakota Legal Forms Health and Safety
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Form OLA-111 Emergency Preparedness Drill Log - South Dakota PDF DOCX

Form OLA-111 Emergency Preparedness Drill Log - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Emergency Preparedness Drilling Log
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Form OLA-106 Certification of Objection to Immunization - South Dakota PDF DOCX

Form OLA-106 Certification of Objection to Immunization - South Dakota
Legal United States Legal Forms Vaccine Exemption Form South Dakota Legal Forms Immunization Exemption Form Religious Exemption Form Immunization Record Form
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Form OLA-109 Serious Incident Reporting Form - South Dakota PDF DOCX

Form OLA-109 Serious Incident Reporting Form - South Dakota
Legal Serious Incident Report Form Incident Report Form United States Legal Forms South Dakota Legal Forms Serious Incident
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Form OLA-104 Child Attendance Record - South Dakota PDF DOCX

Form OLA-104 Child Attendance Record - South Dakota
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Form OLA-118 Written Care Plan for a Child With Allergies - South Dakota PDF DOCX

Form OLA-118 Written Care Plan for a Child With Allergies - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Care Plan Template
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Form OLA-113 Emergency Preparedness and Response Plan Template - South Dakota PDF DOCX

Form OLA-113 Emergency Preparedness and Response Plan Template - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Response Plan Emergency Preparedness
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Form OLA-102 Child Information - South Dakota PDF DOCX

Form OLA-102 Child Information - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Educational Background
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Form OLA-101 Child Care Provider Training Record - South Dakota PDF DOCX

Form OLA-101 Child Care Provider Training Record - South Dakota
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Form MS-114 South Dakota Medicaid Pre-orthodontic Certification Form - South Dakota PDF DOCX

Form MS-114 South Dakota Medicaid Pre-orthodontic Certification Form - South Dakota
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Form OLA-110 Child Care Provider Information - South Dakota PDF DOCX

Form OLA-110 Child Care Provider Information - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Child Care Provider
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Form MS-115 Handicapping Labio-Lingual Deviations Form (Hld Index) - South Dakota PDF DOCX

Form MS-115 Handicapping Labio-Lingual Deviations Form (Hld Index) - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Special Education Speech Therapy
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New Application - South Dakota Indigent Medication Program - South Dakota PDF DOCX

New Application - South Dakota Indigent Medication Program - South Dakota
Legal United States Legal Forms South Dakota Legal Forms
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Update-Extension Request Form - South Dakota Indigent Medication Program - South Dakota PDF DOCX

Update-Extension Request Form - South Dakota Indigent Medication Program - South Dakota
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Behavioral Health Voucher Program (Bhvp) for Child Care Provider Employees (Ccp) Release of Information - South Dakota PDF DOCX

Behavioral Health Voucher Program (Bhvp) for Child Care Provider Employees (Ccp) Release of Information - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Mental Health Employee Benefits Behavioral Health
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Form OLA-114 Licensed School Age Care Programs Located in a School - Floor Plan Review - South Dakota PDF DOCX

Form OLA-114 Licensed School Age Care Programs Located in a School - Floor Plan Review - South Dakota
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Form DSS-SE-408 Request for Child Support Services - South Dakota PDF DOCX

Form DSS-SE-408 Request for Child Support Services - South Dakota
Legal United States Legal Forms Child Support Forms South Dakota Legal Forms Child Support Services
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Form OLA-116 Floor Plan Review Process and Program Proposal - South Dakota PDF DOCX

Form OLA-116 Floor Plan Review Process and Program Proposal - South Dakota
Legal United States Legal Forms South Dakota Legal Forms Program Proposal
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Form OLA-100 Background Screening Information Authorization - South Dakota PDF DOCX

Form OLA-100 Background Screening Information Authorization - South Dakota
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Form DSS-EA-FSSA Application for Health Coverage & Help Paying Costs - South Dakota PDF DOCX

Form DSS-EA-FSSA Application for Health Coverage & Help Paying Costs - South Dakota
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Form DSS-EA-240 Application for Resource Assessment, Long-Term Care, or Other Related Medical Assistance - South Dakota PDF DOCX

Form DSS-EA-240 Application for Resource Assessment, Long-Term Care, or Other Related Medical Assistance - South Dakota
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Form DSS-EA-270 Application for Medicare Savings Programs - South Dakota PDF DOCX

Form DSS-EA-270 Application for Medicare Savings Programs - South Dakota
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Form MS-131 Pre-admission Hospital Exemption to the Nursing Facility or Swing Bed - South Dakota PDF DOCX

Form MS-131 Pre-admission Hospital Exemption to the Nursing Facility or Swing Bed - South Dakota
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Form OLA-101 Orientation and Ongoing Health and Safety Training - South Dakota PDF DOCX

Form OLA-101 Orientation and Ongoing Health and Safety Training - South Dakota
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Form OLA-105 Child Care Provider Annual - South Dakota PDF DOCX

Form OLA-105 Child Care Provider Annual - South Dakota
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Form DSS-NEMT-953 Non-emergency Medical Travel (Nemt) Primary Care Provider (Pcp)/Health Home Provider (Hhp) Questionnaire - South Dakota PDF DOCX

Form DSS-NEMT-953 Non-emergency Medical Travel (Nemt) Primary Care Provider (Pcp)/Health Home Provider (Hhp) Questionnaire - South Dakota
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Form DSS-NEMT-970 South Dakota Medicaid Non-emergency Medical Travel (Nemt) Reimbursement Form - Day Trip - South Dakota PDF DOCX

Form DSS-NEMT-970 South Dakota Medicaid Non-emergency Medical Travel (Nemt) Reimbursement Form - Day Trip - South Dakota
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Form PA-100 Prior Authorization Request Form - South Dakota PDF DOCX

Form PA-100 Prior Authorization Request Form - South Dakota
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Form PA-106 Genetic Testing Prior Authorization Request Form - South Dakota PDF DOCX

Form PA-106 Genetic Testing Prior Authorization Request Form - South Dakota
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Form DSS-NEMT-950.2 South Dakota Medicaid Non-emergency Medical Travel (Nemt) Reimbursement Form - Overnight Trip - South Dakota PDF DOCX

Form DSS-NEMT-950.2 South Dakota Medicaid Non-emergency Medical Travel (Nemt) Reimbursement Form - Overnight Trip - South Dakota
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Form DSS-NEMT-973 South Dakota Medicaid Non-emergency Medical Travel Appointment Verification Form - South Dakota PDF DOCX

Form DSS-NEMT-973 South Dakota Medicaid Non-emergency Medical Travel Appointment Verification Form - South Dakota
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Form PA-101 Durable Medical Equipment Prior Authorization Request Form - South Dakota PDF DOCX

Form PA-101 Durable Medical Equipment Prior Authorization Request Form - South Dakota
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Form PA-104 Private Duty Nursing/Extended Home Health Aide Prior Authorization Request Form - South Dakota PDF DOCX

Form PA-104 Private Duty Nursing/Extended Home Health Aide Prior Authorization Request Form - South Dakota
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Form PA-107 Brca Prior Authorization Request Form - South Dakota PDF DOCX

Form PA-107 Brca Prior Authorization Request Form - South Dakota
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Form PA-112 Long Term Acute Care (Ltac) and Out-of-State Rehab Prior Authorization Request Form - South Dakota PDF DOCX

Form PA-112 Long Term Acute Care (Ltac) and Out-of-State Rehab Prior Authorization Request Form - South Dakota
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Form PA-102 Applied Behavior Analysis Therapy Prior Authorization Request Form - South Dakota PDF DOCX

Form PA-102 Applied Behavior Analysis Therapy Prior Authorization Request Form - South Dakota
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Form DSS-EA-301MA Children and Family Medical Assistance Supplemental Application - South Dakota PDF DOCX

Form DSS-EA-301MA Children and Family Medical Assistance Supplemental Application - South Dakota
Legal United States Legal Forms South Dakota Legal Forms
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