Oklahoma Department of Human Services
Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd. • Oklahoma City, OK 73105
(405) 521-3646 • Fax (405) 521-6684 • Internet: www.okdhs.org
 
Library: Forms
OKDHS Forms
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Other Form Links
36 forms found     
View Form No.Results shown in ascending orderLegacy No.Form Name Category
Open Specialized Foster Care/Agency Companion Services Application (.doc, 2 pp, 574 KB)Open Specialized Foster Care/Agency Companion Services Application (.pdf, 2 pp, 191 KB)
06AC008E
DDS-8Specialized Foster Care/Agency Companion Services ApplicationDevelopmental Disabilities  
Open Medical Examination Report (.doc, 1 pp, 509 KB)Open Medical Examination Report Instructions (.pdf, 1 pp, 11 KB)
06AC010E
DDS-10Medical Examination Report Developmental Disabilities  
Open Fire and Weather Drill Record (.doc, 1 pp, 574 KB)
06AC021E
DDS-21Fire and Weather Drill RecordDevelopmental Disabilities  
Open Site Visit Report (.doc, 1 pp, 656 KB)Open Site Visit Report (.pdf, 1 pp, 130 KB)
06CB035E
DDS-35Site Visit ReportDevelopmental Disabilities  
Open Monthly Summary of Restrictive/Intrusive Procedure Usage (.doc, 2 pp, 694 KB)Open Monthly Summary of Restrictive/Intrusive Procedure Usage (.pdf, 2 pp, 184 KB)
06CB055E
N/AMonthly Summary of Restrictive/Intrusive Procedure UsageDevelopmental Disabilities  
Open Provider Progress Report (.doc,  pp, 711 KB)Open Provider Progress Report (.pdf, 2 pp, 173 KB)
06CB062E
DDS-62Provider Progress ReportDevelopmental Disabilities  
Open Family Support Assistance Payment Services Application (.pdf, 3 pp, 235 KB)
06DA031E
DDS-031Family Support Assistance Payment Services ApplicationDevelopmental Disabilities  
Open Referral Form for Examination or Treatment (.doc, 1 pp, 688 KB)Open Referral Form for Examination or Treatment Instructions (.pdf, 1 pp, 25 KB)
06HM005E
DDS-5Referral Form for Examination or Treatment Developmental Disabilities  
Open Health Status and Monthly Medication Review (formerly DDS-6 (.pdf, 2 pp, 566 KB)
06HM006E
Health Status and Monthly Medication Review (formerly DDS-6Developmental Disabilities  
Open Level of Nutritional Risk Assessment (.doc, 3 pp, 1.0 MB)Open Level of Nutritional Risk Assessment (.pdf, 3 pp, 215 KB)
06HM040E
DDS-40Level of Nutritional Risk AssessmentDevelopmental Disabilities  
Open Annual Psychotropic Medication Review (.doc, 2 pp, 767 KB)Open Annual Psychotropic Medication Review (.pdf, 2 pp, 156 KB)
06HM067E
DDS-67Annual Psychotropic Medication ReviewDevelopmental Disabilities  
Open Referral Form for Psychiatric Treatment or Examination (.pdf, 2 pp, 1.0 MB)
06HM073E
N/AReferral Form for Psychiatric Treatment or ExaminationDevelopmental Disabilities  
Open In-Home Supports Waiver -  Certificate of Competency (.pdf, 2 pp, 569 KB)
06IS037E
DDS-37In-Home Supports Waiver - Certificate of CompetencyDevelopmental Disabilities  
Open In-Home Supports Waiver - Family Members Statement (.doc, 2 pp, 662 KB)Open In-Home Supports Waiver - Family Members Statement (.pdf, 2 pp, 140 KB)
06IS038E
DDS-038In-Home Supports Waiver - Family Member's StatementDevelopmental Disabilities  
Open Application for BCBA and BCaBA Certification (.doc, 2 pp, 235 KB)Open Application for BCBA License and BCaBA Certification (.pdf, 3 pp, 220 KB)
06LC001E
N/AApplication for BCBA License and BCaBA CertificationDevelopmental Disabilities  
Open Professional Reference for BCBA License and BCaBA Certification (.doc, 1 pp, 247 KB)Open Professional Reference for BCBA License and BCaBA Certification (.pdf, 1 pp, 140 KB)
06LC002E
N/AProfessional Reference for BCBA License and BCaBA CertificationDevelopmental Disabilities  
Open Certification of Autism Internship/Practicum Designation for BCBA License (.doc, 1 pp, 2354 KB)Open Certification of Autism Internship/Practicum Designation for BCBA License (.pdf, 1 pp, 132 KB)
06LC003E
N/ACertification of Autism Internship/Practicum Designation for BCBA LicenseDevelopmental Disabilities  
Open Statement of Professional Disclosure for BCBA License and BCaBA Certification (.doc, 1 pp, 227 KB)Open Statement of Professional Disclosure for BCBA License and BCaBA Certification (.pdf, 1 pp, 129 KB)
06LC004E
N/AStatement of Professional Disclosure for BCBA License and BCaBA CertificationDevelopmental Disabilities  
Open BCaBA Professional Supervision (.doc, 1 pp, 226 KB)Open BCaBA Professional Supervision (.pdf, 1 pp, 123 KB)
06LC005E
N/ABCaBA Professional SupervisionDevelopmental Disabilities  
Open Board Certified Behavior Analyst (BCBA) and Board Certified Assistant Behavior Analyst (BCaBA) Complaints (.doc, 2 pp, 242 KB)Open Board Certified Behavior Analyst (BCBA) and Board Certified Assistant Behavior Analyst (BCaBA) Complaints (.pdf, 2 pp, 141 KB)
06LC006E
N/ABoard Certified Behavior Analyst (BCBA) and Board Certified Assistant Behavior Analyst (BCaBA) ComplaintsDevelopmental Disabilities  
Open Request for Developmental Disabilities Services (.pdf, 5 pp, 680 KB)
06MP001E
DDS-1Request for Developmental Disabilities ServicesDevelopmental Disabilities  
Open Capacity Assessment (.doc, 1 pp, 1.2 MB)Open Capacity Assessment (.pdf, 17 pp, 641 KB)
06MP032E
N/ACapacity AssessmentDevelopmental Disabilities  
Open Guardianship, Advocacy, and Capacity Initial Review (.doc, 1 pp, 819 KB)Open Guardianship, Advocacy, and Capacity Initial Review (.pdf, 1 pp, 153 KB)
06MP033E
N/AGuardianship, Advocacy, and Capacity Initial ReviewDevelopmental Disabilities  
Open Guardianship, Advocacy, and Capacity Annual Review (.doc, 1 pp, 733 KB)Open Guardianship, Advocacy, and Capacity Annual Review (.pdf, 1 pp, 131 KB)
06MP034E
N/AGuardianship, Advocacy, and Capacity Annual ReviewDevelopmental Disabilities  
Open Incident Report (.pdf, 3 pp, 574 KB)
06MP046E
DDS-46Incident ReportDevelopmental Disabilities  
Open Notice of Responsibilities Regarding Online Training (.doc, 1 pp, 158 KB)Open Notice of Responsibilities Regarding Online Training (.pdf, 1 pp, 132 KB)
06MP050E
N/ANotice of Responsibilities Regarding Online TrainingDevelopmental Disabilities  
Open Access to Record and Verification of Monitoring Requirements (.doc, 3 pp, 259 KB)Open Access to Record and Verification of Monitoring Requirements (.pdf, 3 pp, 380 KB)
06MP070E
N/AAccess to Record and Verification of Monitoring RequirementsDevelopmental Disabilities  
Open Employment Application Supplement (.doc, 1 pp, 720 KB)Open Employment Application Supplement (.pdf, 1 pp, 120 KB)
06PE039E
DDS-39Employment Application SupplementDevelopmental Disabilities  
Open Rights and Responsibilities of Community Services Worker in an Investigation of Maltreatment (.doc, 1 pp, 723 KB)Open Rights and Responsibilities of Community Services Worker in an Investigation of Maltreatment (.pdf, 1 pp, 120 KB)
06PE059E
DDS-59Rights and Responsibilities of Community Services Worker in an Investigation of MaltreatmentDevelopmental Disabilities  
Open Monthly Attendance Record (.pdf, 3 pp, 652 KB)
06WP044E
DDS-44Monthly Attendance RecordDevelopmental Disabilities  
Open Adult Day Services Progress Report (.doc, 5 pp, 172 KB)Open Adult Day Services Progress Report (.pdf, 5 pp, 144 KB)
06WP046E
N/AAdult Day Services Progress ReportDevelopmental Disabilities  
Open Exception Request for Waiver Employment Services (.doc, 2 pp, 683 KB)Open Exception Request for Waiver Employment Services (.pdf, 2 pp, 163 KB)
06WP047E
N/AException Request for Waiver Employment ServicesDevelopmental Disabilities  
Open Employment Progress Report (.doc, 2 pp, 1.2 MB)Open Employment Progress Report (.pdf, 2 pp, 181 KB)
06WP066E
DDS-066Employment Progress ReportDevelopmental Disabilities  
Open HB 1094 Compliance Report (.xls, 27 KB)
HB1094CR
N/AHB 1094 Compliance ReportDevelopmental Disabilities  
Open HB 1094 Compliance Report Instructions (.pdf, 4 pp, 37 KB)
HB1094E
N/AHB 1094 Compliance Report InstructionsDevelopmental Disabilities  
Open HB 1094 Compliance Report Provider Letter (.pdf, 1 pp, 53 KB)
HB1094PL
N/AHB 1094 Compliance Report Provider LetterDevelopmental Disabilities  
   
Last Updated:  9/19/2014