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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

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Last Updated:  11/12/2009
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OKDHS Home > Library > Forms > Forms and Applications for Services
Library: Forms
OKDHS Forms
To view these forms, please choose the associated icon under the View column. In order to view the forms correctly, site guests may need additional software. In some cases, forms are saved as .pdf or .doc files. To take full advantage of the OKDHS content, get the latest versions of Adobe Acrobat Reader or Microsoft Word Viewer from the Downloads and Plug-ins page.
Formas
61 forms found    Page 1  2   
View Form No.Results shown in ascending orderLegacy No.Form Name Category
Open KIDS Application Logon Request for Non-DHS Employees (.doc, 1 pp, 1.1 MB)Open KIDS Application Logon Request for Non-DHS Employees (.pdf, 1 pp, 275 KB)Open KIDS Application Logon Request for Non-DHS Employees Instructions (.pdf, 1 pp, 12 KB)
04AD001E
CWS-KIDS-102KIDS Application Logon Request for Non-DHS EmployeesChild Welfare  
Open Request for Background Check (.doc, 1 pp, 588 KB)
04AD003E
ADM-130Request for Background CheckChild Welfare  
Open Bridge Resource Family Assessment Application (.doc, 4 pp, 868 KB)Open Bridge Resource Family Assessment Application (.pdf, 4 pp, 275 KB)Open Bridge Resource Family Assessment Application Instructions (.pdf, 1 pp, 11 KB)
04AF001E
DCFS-026Bridge Resource Family Assessment ApplicationChild Welfare  
Open Guidelines for Resource Family Assessment - Bridge Family Profile (.doc, 40 pp, 1.1 MB)Open Guidelines for Resource Family Assessment - Bridge Family Profile (.pdf, 39 pp, 300 KB)
04AF002E
DCFS-069Guidelines for Resource Family Assessment - Bridge Family ProfileChild Welfare  
Open Resource Family Assessment - Bridge Family Profile (.doc, 27 pp, 1.7 MB)Open Resource Family Assessment - Bridge Family Profile (.pdf, 27 pp, 462 KB)Open Resource Family Assessment - Bridge Family Profile Instructions (.pdf, 1 pp, 12 KB)
04AF003E
DCFS-069-AResource Family Assessment - Bridge Family ProfileChild Welfare  
Open House Assessment (.doc, 5 pp, 751 KB)Open House Assessment (.pdf, 5 pp, 397 KB)
04AF004E
DCFS-11House AssessmentChild Welfare  
Open Medical Examination Report (.doc, 1 pp, 103 KB)Open Medical Examination Report (.pdf, 1 pp, 141 KB)
04AF008E
DCFS-038Medical Examination ReportChild Welfare  
Open Referral for Bridge Resource Family Assessment (.doc, 3 pp, 723 KB)Open Referral for Bridge Resource Family Assessment (.pdf, 3 pp, 216 KB)
04AF009E
DCFS-067Referral for Bridge Resource Family AssessmentChild Welfare  
Open Resource Family Financial Assessment (.doc, 3 pp, 1.3 MB)Open Resource Family Financial Assessment (.pdf, 3 pp, 195 KB)Open Resource Family Financial Assessment Instructions (.pdf, 1 pp, 12 KB)
04AF010E
DCFS-020Resource Family Financial AssessmentChild Welfare  
Open Resource Family Reference Letter for an Employer (.doc, 2 pp, 1.2 MB)Open Resource Family Reference Letter for an Employer (.pdf, 2 pp, 156 KB)Open Resource Family Reference Letter for an Employer Instructions (.pdf, 1 pp, 19 KB)
04AF011E
DCFS-48Resource Family Reference Letter for an EmployerChild Welfare  
Open Childs Mental Health Reference Letter (.doc, 3 pp, 1232 KB)Open Childs Mental Health Reference Letter (.pdf, 3 pp, 174 KB)Open Childs Mental Health Reference Letter Instructions (.pdf, 1 pp, 28 KB)
04AF012E
DCFS-065-AChild's Mental Health Reference LetterChild Welfare  
Open Resource Family Assessment Reference Letter for Mental Health Professionals (.doc, 3 pp, 892 KB)Open Resource Family Assessment Reference Letter for Mental Health Professionals (.pdf, 3 pp, 181 KB)Open Resource Family Assessment Reference Letter for Mental Health Professionals Instructions (.pdf, 1 pp, 20 KB)
04AF013E
DCFS-065Resource Family Assessment Reference Letter for Mental Health ProfessionalsChild Welfare  
Open Resource Family Reference Letter for School Personnel (.doc, 2 pp, 1.2 MB)Open Resource Family Reference Letter for School Personnel (.pdf, 2 pp, 228 KB)Open Resource Family Reference Letter for School Personnel Instructions (.pdf, 1 pp, 19 KB)
04AF014E
DCFS-043Resource Family Reference Letter for School PersonnelChild Welfare  
Open Resource Family Reference Letter for Adult Children (.doc, 4 pp, 1.2 MB)Open Resource Family Reference Letter for Adult Children (.pdf, 4 pp, 199 KB)Open Resource Family Reference Letter for Adult Children Instructions (.pdf, 1 pp, 12 KB)
04AF015E
DCFS-039Resource Family Reference Letter for Adult ChildrenChild Welfare  
Open Resource Family Personal Reference Letter (.doc, 3 pp, 1.2 MB)Open Resource Family Personal Reference Letter (.pdf, 3 pp, 459 KB)Open Resource Family Personal Reference Letter Instructions (.pdf, 1 pp, 21 KB)
04AF016E
DCFS-064Resource Family Personal Reference LetterChild Welfare  
Open Family Health History (.doc, 3 pp, 880 KB)Open Family Health History (.pdf, 3 pp, 254 KB)
04AF017E
DCFS-042Family Health HistoryChild Welfare  
Open Child Needs Information List (.doc, 3 pp, 1.3 MB)Open Child Needs Information List (.pdf, 3 pp, 476 KB)Open Child Needs Information List Instructions (.pdf, 1 pp, 12 KB)
04AF018E
DCFS-063Child Needs Information ListChild Welfare  
Open Childs Questionnaire (.doc, 2 pp, 521 KB)Open Childs Questionnaire (.pdf, 2 pp, 145 KB)Open Childs Questionnaire Instructions (.pdf, 1 pp, 12 KB)
04AF019E
DCFS-062Child's QuestionnaireChild Welfare  
Open Family/Parent Questionnaire (.doc, 9 pp, 731 KB)Open Family/Parent Questionnaire (.pdf, 9 pp, 190 KB)Open Family/Parent Questionnaire Instructions (.pdf, 1 pp, 11 KB)
04AF020E
DCFS-061Family/Parent QuestionnaireChild Welfare  
Open Resource Family Reference Letter for Home Schooling (.doc, 2 pp, 1.2 MB)Open Resource Family Reference Letter for Home Schooling (.pdf, 2 pp, 166 KB)Open Resource Family Reference Letter for Home Schooling Instructions (.pdf, 1 pp, 12 KB)
04AF025E
N/AResource Family Reference Letter for Home SchoolingChild Welfare  
Open Alternate Caregiver Reference Letter (.doc, 3 pp, 545 KB)Open Alternate Caregiver Reference Letter (.pdf, 3 pp, 155 KB)Open Alternate Caregiver Reference Letter Instructions (.pdf, 1 pp, 12 KB)
04AF026E
N/AAlternate Caregiver Reference LetterChild Welfare  
Open Directive Authorizing Consent to Adoption (.doc, 1 pp, 526 KB)Open Directive Authorizing Consent to Adoption (.pdf, 1 pp, 220 KB)
04AN013E
DCFS-045Directive Authorizing Consent to AdoptionChild Welfare  
Open Centralized Paternity Registry (.doc, 1 pp, 105 KB)Open Centralized Paternity Registry (.pdf, 1 pp, 151 KB)Open Centralized Paternity Registry Instructions (.pdf, 1 pp, 35 KB)
04AN016E
DCFS-40Centralized Paternity RegistryChild Welfare  
Open Child Profile Assessment for Adoption (.doc, 6 pp, 793 KB)Open Child Profile Assessment for Adoption (.pdf, 6 pp, 200 KB)
04AN022E
DCFS-29Child Profile Assessment for AdoptionChild Welfare  
Open Adoptive Placement Recommendation - Supplemental Worksheet (.doc, 2 pp, 275 KB)Open Adoptive Placement Recommendation - Supplemental Worksheet (.pdf, 2 pp, 172 KB)
04AN025E
DCFS-091-AAdoptive Placement Recommendation - Supplemental WorksheetChild Welfare  
Open Request for Child Abuse and Neglect Information System Search (.doc, 3 pp, 842 KB)Open Request for Child Abuse and Neglect Information System Search (.pdf, 3 pp, 202 KB)
04AN028E
DCFS-125Request for Child Abuse and Neglect Information System SearchChild Welfare  
Open Community-Based Residential Care (CBRC) Leave Tracking (.doc, 10 pp, 547 KB)Open Community-Based Residential Care (CBRC) Leave Tracking (.pdf, 5 pp, 42 KB)Open Community-Based Residential Care (CBRC) Leave Tracking Instructions (.pdf, 1 pp, 23 KB)
04CB001E
DCFS-126Community-Based Residential Care (CBRC) Leave TrackingChild Welfare  
Open CFSD Claim for Purchase of Residential Care (.doc, 1 pp, 54 KB)Open CFSD Claim for Purchase of Residential Care Instructions (.pdf, 1 pp, 29 KB)
04CB002E
DCYS-S-002CFSD Claim for Purchase of Residential Care Child Welfare  
Open Independent Living Youth Exit Interview (.doc, 2 pp, 685 KB)Open Confidential Intermediary Statistical Information (.pdf, 2 pp, 177 KB)
04CI003E
DCFS-33Confidential Intermediary Statistical InformationChild Welfare  
Open Confidential Intermediary Results Report (.doc, 2 pp, 676 KB)Open Confidential Intermediary Results Report (.pdf, 2 pp, 136 KB)
04CI007E
DCFS-30Confidential Intermediary Results ReportChild Welfare  
Open Confidential Intermediary Certification Application (.doc, 4 pp, 744 KB)Open Confidential Intermediary Certification Application (.pdf, 4 pp, 195 KB)
04CI009E
DCFS-24Confidential Intermediary Certification ApplicationChild Welfare  
Open Clothing Inventory (.doc, 1 pp, 702 KB)Open Clothing Inventory (.pdf, 1 pp, 138 KB)
04FC004E
DCFS-118Clothing InventoryChild Welfare  
Open Contact Log (.pdf, 1 pp, 16 KB)Open Contact Log Instructions (.pdf, 1 pp, 19 KB)
04FE001E
DCFS-EFC-010Contact LogChild Welfare  
Open Personal Item Checklist (.doc, 2 pp, 682 KB)Open Personal Item Checklist (.pdf, 2 pp, 153 KB)Open Personal Item Checklist Instructions (.pdf, 1 pp, 12 KB)
04FE002E
DCFS-EFC-7Personal Item ChecklistChild Welfare  
Open Request for Rate Increase (.doc, 1 pp, 692 KB)Open Request for Rate Increase (.pdf, 1 pp, 116 KB)Open Request for Rate Increase Instructions (.pdf, 1 pp, 18 KB)
04FE003E
DCFS-EFC-1Request for Rate IncreaseChild Welfare  
Open AWOL Report (DCFS-EFC-2) (.doc, 1 pp, 698 KB)Open AWOL Report (DCFS-EFC-2) (.pdf, 1 pp, 131 KB)
04FE004E
04FE004EAWOL Report (DCFS-EFC-2)Child Welfare  
Open School Report (.doc, 1 pp, 662 KB)Open School Report (.pdf, 1 pp, 129 KB)Open School Report Instructions (.pdf, 1 pp, 81 KB)
04FE005E
DCFS-EFC-8School ReportChild Welfare  
Open Developmental Behavioral Checklist (.doc, 3 pp, 877 KB)Open Developmental Behavioral Checklist (.pdf, 2 pp, 220 KB)Open Developmental Behavioral Checklist Instructions (.pdf, 1 pp, 11 KB)
04FE006E
DCFS-EFC-9Developmental Behavioral ChecklistChild Welfare  
Open Change of Emergency Foster Care Placement (.doc, 1 pp, 520 KB)Open Change of Emergency Foster Care Placement (.pdf, 1 pp, 139 KB)Open Change of Emergency Foster Care Placement Instructions (.pdf, 1 pp, 10 KB)
04FE007E
DCFS-EFC-4Change of Emergency Foster Care PlacementChild Welfare  
Open Authorization for Hospital Discharge (.doc, 1pp, 653 KB)Open Authorization for Hospital Discharge (.pdf, 1 pp, 157 KB)Open Authorization for Hospital Discharge Instructions (.pdf, 1 pp, 18 KB)
04FE008E
DCFS-EFC-5Authorization for Hospital DischargeChild Welfare  
Open Authorization for Foster Parent Consent for Medical Services (.pdf, 1 pp, 26 KB)Open Authorization for Foster Parent Consent for Medical Services Instructions (.pdf, 1 pp, 19 KB)
04FE009E
DCFS-EFC-012Authorization for Foster Parent Consent for Medical ServicesChild Welfare  
Open Appointment Log (.pdf, 2 pp, 19 KB)Open Appointment Log Instructions (.pdf, 1 pp, 26 KB)
04FE010E
DCFS-EFC-006Appointment LogChild Welfare  
Open Authorization for Foster Parent Consent for Medical Services - Emergency Custody (.pdf, 1 pp, 26 KB)Open Authorization for Foster Parent Consent for Medical Services - Emergency Custody Instructions (.pdf, 1 pp, 19 KB)
04FE011E
DCFS-EFC-011Authorization for Foster Parent Consent for Medical Services - Emergency CustodyChild Welfare  
Open CFSD Claim for Purchase of Therapeutic Foster Care (.doc, 1 pp, 55 KB)Open CFSD Claim for Purchase of Therapeutic Foster Care Instructions (.pdf, 1 pp, 15 KB)
04FT001E
DCFS-128CFSD Claim for Purchase of Therapeutic Foster Care Child Welfare  
Open Leave Tracking (.pdf, 1 pp, 22 KB)Open Leave Tracking Instructions (.pdf, 1 pp, 19 KB)
04FT002E
DCFS-TFC-003Leave TrackingChild Welfare  
Open Request for Third Placement (.pdf, 5 pp, 39 KB)
04FT003E
DCFS-TFC-002Request for Third PlacementChild Welfare  
Open Notice of Childs Location (.pdf, 3 pp, 34 KB)
04FT004E
DCFS-TFC-001Notice of Child's LocationChild Welfare  
Open Out-of-State Placement Request Checklist (.doc, 2 pp, 662 KB)Open Out-of-State Placement Request Checklist (.pdf, 2 pp, 200 KB)
04IC006E
ICPC-107Out-of-State Placement Request ChecklistChild Welfare  
Open Financial/Medical Plan (.doc, 2 pp, 673 KB)Open Financial/Medical Plan (.pdf, 2 pp, 161 KB)
04IC012E
ICPC-104Financial/Medical PlanChild Welfare  
Open Independent Living Youth Exit Interview Instructions (.pdf, 1 pp, 21 KB)
04IL003E
DCFS-087Independent Living Youth Exit Interview InstructionsChild Welfare  
Page 1  2     
Street address: Oklahoma Department of Human Services
Sequoyah Memorial Office Building, 2400 N. Lincoln Blvd., Oklahoma City, OK 73105
Mailing address: P.O. Box 25352, Oklahoma City, OK 73125
(405) 521-3646