Initial Application Forms

Most application forms are currently available on the DHS Forms website. Use the numbers provided below to find the forms:

  • License Application, SDS 0654
  • Application Instruction Sheet, SDS 0654i
  • Foster Home Medicaid Provider Enrollment Agreement, SDS 0738
  • Plan of Daily Operation, SDS 0656
  • Consent for Release of Information, SDS 4533A
  • AFH Financial Information, SDS 0448A

The following forms are also required, but they are not currently available on the DHS Forms website. You can download them here.