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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:  11/19/2009
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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
307 forms found    Page 1  2  3  4  5  6  7   
View Form No.Results shown in descending orderLegacy No.Form Name Category
Open Sample Petitions and Court Orders (.pdf, 14 pp, 92 KB)
ST005E
13AX001ESample Petitions and Court OrdersLegal  
Appendices  
Open OKDHS Document Category Codes (.pdf, 6 pp, 120 KB)
ST004E
21AX004EOKDHS Document Category CodesGeneral Use  
Appendices  
Open OKDHS Document Division Codes (.pdf, 8 pp, 66 KB)
ST003E
21AX003EOKDHS Document Division CodesGeneral Use  
Appendices  
Open OKDHS Document Standards (.pdf, 8 pp, 101 KB)
ST002E
21AX002EOKDHS Document StandardsGeneral Use  
Appendices  
Open Its All About Your Genes 06/25/2009 (.pdf, 1 pp, 170 KB)
OCSS-13
CSED-13It's All About Your Genes 06/25/2009Child Support  
Appendices  
Open MOSAIC Logo Guidelines (.pdf, 7 pp, 564 KB)
MO-1
N/AMOSAIC Logo GuidelinesAppendices  
Open Job Descriptions for Older Americans Act Network Employees (.pdf, 61 pp, 340 KB)
M-14
02AX009EJob Descriptions for Older Americans Act Network EmployeesAppendices  
Aging  
Open Eligibility Schedule/Rates for Adult Day Services (.pdf, 1 pp, 59 KB)
M-105
02AX010EEligibility Schedule/Rates for Adult Day ServicesAppendices  
Adult Day Services  
Open Child Care Center Exclusion Criteria for Children Who Are III 09/15/2007 (.pdf, 2 pp, 70 KB)
L-6
07AX006EChild Care Center Exclusion Criteria for Children Who Are III 09/15/2007Child Care Licensing  
Appendices  
Open HB 1094 Compliance Report Provider Letter (.pdf, 1 pp, 53 KB)
HB1094PL
N/AHB 1094 Compliance Report Provider LetterDevelopmental 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 (.xls, 27 KB)
HB1094CR
N/AHB 1094 Compliance ReportDevelopmental Disabilities  
Open Directory - Congregate Meals Program 09/10/09 (.pdf, 30 pp, 589 KB)
D-20
02AX007EDirectory - Congregate Meals Program 09/10/09Appendices  
Aging  
Open Cooperative Intake (.pdf, 2 pp, 19 KB)
CO001
CO-001Cooperative IntakeGeneral Use  
Open Low Income Home Energy Assistance Program - Income and Resource Level by Household Size (.pdf, 1 pp, 52 KB)
C-7
08AX039ELow Income Home Energy Assistance Program - Income and Resource Level by Household SizeLIHEAP  
Appendices  
Open Child Care Provider Rate Schedule 01/01/2009 (.pdf, 7 pp, 129 KB)
C-4-B
APPENDIX 08AX006EChild Care Provider Rate Schedule 01/01/2009Child Care  
Child Care Licensing  
Appendices  
Open Child Care Eligibility/Rates Schedule 06/01/2008 (.pdf, 9 pp, 93 KB)
C-4
08AX005EChild Care Eligibility/Rates Schedule 06/01/2008Child Care  
Appendices  
Open Maximum Income Limits and Benefit Allotments for FNS Declared Disasters 10/01/2009 (.pdf, 1 pp, 52 KB)
C-3-A
08AX004EMaximum Income Limits and Benefit Allotments for FNS Declared Disasters 10/01/2009Food Stamps  
Appendices  
Open Maximum Food Benefit Allotments and Standards for Income and Deductions 10/01/2009 (.pdf, 37 pp, 860 KB)
C-3_092_10012009
08AX003EMaximum Food Benefit Allotments and Standards for Income and Deductions 10/01/2009Food Stamps  
Open Maximum Food Benefit Allotments and Standards for Income and Deductions 10/01/2009 (.pdf, 37 pp, 860 KB)
C-3
08AX003EMaximum Food Benefit Allotments and Standards for Income and Deductions 10/01/2009Appendices  
Open Title III Reports Schedule (.pdf, 2 pp, 74 KB)
C-21
02AX006ETitle III Reports ScheduleAppendices  
Aging  
Open Children and Family Services Division Rates Schedule 01/01/2009 (.pdf, 9 pp, 109 KB)
C-20_097_01012009
04AX003EChildren and Family Services Division Rates Schedule 01/01/2009Appendices  
Open Children and Family Services Division Rates Schedule 01/01/2009 (.pdf, 9 pp, 109 KB)
C-20
04AX003EChildren and Family Services Division Rates Schedule 01/01/2009Child Welfare  
Open Standards for Expanded Medical Coverage Indicator (.doc, 1 pp, 659 KB)Open Standards for Expanded Medical Coverage Indicator (.pdf, 1 pp, 88 KB)
C-1-A
08AX010EStandards for Expanded Medical Coverage IndicatorMedical  
Appendices  
Open Child Support Services and Responsibilities (.pdf, 4 pp, 100 KB)
C-16
03AX016EChild Support Services and ResponsibilitiesChild Support  
Appendices  
Open Maximum Income, Resource, and Payment Standards 10/01/2009 (.pdf, 8 pp, 115 KB)
C-1
08AX001EMaximum Income, Resource, and Payment Standards 10/01/2009Multiple Programs  
Appendices  
Open Eligibility Requirements for Long-Term Care Programs (.pdf, 2 pp, 45 KB)
A-8
02AX005EEligibility Requirements for Long-Term Care ProgramsAppendices  
Aging  
Open Long-Term Care (LTC) Services (.pdf, 2 pp, 82 KB)
A-7
02AX004ELong-Term Care (LTC) ServicesAppendices  
Aging  
Open Older Americans Act - Title III Acronyms, 12/15/2003 (.pdf, 2 pp, 27 KB)
A-4
02AX001EOlder Americans Act - Title III Acronyms, 12/15/2003Appendices  
Aging  
Open Facts About the Sales Tax Relief Act (.pdf, 1 pp, 57 KB)
A-3
08AX031EFacts About the Sales Tax Relief ActMultiple Programs  
Appendices  
Open Staff Application (.doc, 3 pp, 713 KB)Open Staff Application (.pdf, 3 pp, 218 KB)
24YL006E
YLF-002Staff ApplicationDevelopmental Disabilities Council  
Applications  
Open Strengths, Assets, and Goals Worksheet (.doc, 4 pp, 704 KB)Open Strengths, Assets, and Goals Worksheet (.pdf, 4 pp, 168 KB)
24YL005E
N/AStrengths, Assets, and Goals WorksheetDevelopmental Disabilities Council  
Open Release for Use of Photographs and Quotations (.doc, 1 pp, 659 KB)Open Release for Use of Photographs and Quotations (.pdf, 1 pp, 145 KB)
24YL004E
YLF-004Release for Use of Photographs and QuotationsDevelopmental Disabilities Council  
Open Delegate Information and Request for Accommodations (.doc, 4 pp, 944 KB)Open Delegate Information and Request for Accommodations (.pdf, 4 pp, 314 KB)
24YL003E
YLF-003Delegate Information and Request for AccommodationsDevelopmental Disabilities Council  
Open Application for Oklahoma Youth Leadership Forum (YLF), Part II (.doc, 5 pp, 899 KB)Open Application for Oklahoma Youth Leadership Forum (YLF), Part II (.pdf, 5 pp, 205 KB)
24YL002E
N/AApplication for Oklahoma Youth Leadership Forum (YLF), Part IIDevelopmental Disabilities Council  
Applications  
Open Application for Oklahoma Youth Leadership Forum (YLF), Part I (.doc, 3 pp, 732 KB)Open Application for Oklahoma Youth Leadership Forum (YLF), Part I (.pdf, 3 pp, 233 KB)
24YL001E
N/AApplication for Oklahoma Youth Leadership Forum (YLF), Part IDevelopmental Disabilities Council  
Applications  
Open Application for Master of Social Work Stipend (.doc, 2 pp, 1.3 MB)Open Application for Master of Social Work Stipend (.pdf, 2 pp, 141 KB)
24ED001E
MSW-001Application for Master of Social Work StipendDevelopmental Disabilities Council  
Applications  
Open Staff Activity Summary (.pdf, 1 pp, 18 KB)
24DC008E
ODDC-003Staff Activity SummaryDevelopmental Disabilities Council  
Open Application for Participants (.doc, 6 pp, 1.2 MB)Open Application for Participants (.pdf, 6 pp, 332 KB)
24DC007E
ODDC-007Application for ParticipantsDevelopmental Disabilities Council  
Applications  
Open Activity Sheets (.pdf, 1 pp, 28 KB)
24DC006E
ODDC-006Activity SheetsDevelopmental Disabilities Council  
Open Request for Contract Reimbursement (.pdf, 1 pp, 18 KB)
24DC005E
ODDC-005Request for Contract ReimbursementDevelopmental Disabilities Council  
Open Quarterly Progress Report (.pdf, 1 pp, 18 KB)
24DC004E
ODDC-004Quarterly Progress ReportDevelopmental Disabilities Council  
Open Participant Activity Summary (.doc, 1 pp, 211 KB)Open Participant Activity Summary (.pdf, 1 pp, 162 KB)
24DC003E
ODDC-003-AParticipant Activity SummaryDevelopmental Disabilities Council  
Open Application to Serve (.doc, 3 pp, 762 KB)Open Application to Serve (.pdf, 3 pp, 308 KB)
24DC001E
ODDC-1Application to ServeDevelopmental Disabilities Council  
Applications  
Open Leave Option Election - Work-related Accident/Illnesss (.doc, 1 pp, 584 KB)Open Leave Option Election - Work-related Accident/Illnesss (.pdf, 1 pp, 160 KB)Open Leave Option Election - Work-related Accident/Illnesss Instructions (.pdf, 1 pp, 11 KB)
23RS113E
ADM-113Leave Option Election - Work-related Accident/IllnesssRisk Management  
Open Risk Management Survey (.doc, 3 pp, 755 KB)Open Risk Management Survey Instructions (.pdf, 1 pp, 43 KB)
23RS109E
ADM-109Risk Management SurveyRisk Management  
Open Employees Report of Job-Related Accidental Injury or Illness (.doc, 4 pp, 723 KB)Open Employees Report of Job-Related Accidental Injury or Illness (.pdf, 4 pp, 163 KB)Open Employees Report of Job-Related Accidental Injury or Illness Instructions (.pdf, 1 pp, 11 KB)
23RS046E
ADM-46Employee's Report of Job-Related Accidental Injury or IllnessRisk Management  
Open Request to Review and/or Copy Records (.doc, 1 pp, 755 KB)Open Request to Review and/or Copy Records (.pdf, 1 pp, 190 KB)Open Request to Review and/or Copy Records Instructions (.pdf, 2 pp, 14 KB)
23RM023E
PA-23-BRequest to Review and/or Copy RecordsGeneral Use  
Open Fresh Fruit and Vegetable Program (.doc, 2 pp, 1.3 MB)Open Fresh Fruit and Vegetable Program (.pdf, 2 pp, 85 KB)
23CD010E
N/AFresh Fruit and Vegetable ProgramCommodities  
Open Civil Rights Pre-Award Compliance (.doc, 2 pp, 690 KB)Open Civil Rights Pre-Award Compliance (.pdf, 2 pp, 158 KB)
23CD009E
N/ACivil Rights Pre-Award ComplianceCommodities  
Civil Rights  
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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