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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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Learn about the Oklahoma 2-1-1 Advisory Collaborative, which is committed to the implementation of single points of entry to health and human services across Oklahoma


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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
311 forms found    Page 1  2  3  4  5  6  7   
View Form No.Legacy No.Form NameResults shown in ascending order Category
Open Accounting - Recipients Personal Funds and Property (.doc, 1 pp, 667 KB)Open Accounting - Recipients Personal Funds and Property (.pdf, 1 pp, 11 KB)Open Accounting - Recipients Personal Funds and Property Instructions (.pdf, 1 pp, 23 KB)
08MA085E
ABCDM-096-AAccounting - Recipient's Personal Funds and PropertyAging  
Medical  
Open Acknowledment of Paternity (.doc, 3 pp, 215 KB)Open Acknowledment of Paternity (.pdf, 2 pp, 176 KB)
03PA209E
CSED-209Acknowledment of PaternityChild Support  
Open Activity Sheets (.pdf, 1 pp, 28 KB)
24DC006E
ODDC-006Activity SheetsDevelopmental Disabilities Council  
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 Adult Childs (18 Years or Older) Consent (.doc, 2 pp, 672 KB)Open Adult Childs (18 Years or Older) Consent (.pdf, 1 pp, 132 KB)
03PA212E
CSED-209-CAdult Child's (18 Years or Older) ConsentChild Support  
Open Adult Day Service Invoice (.doc, 1 pp, 82 KB)Open Adult Day Service Invoice Instructions (.pdf, 2 pp, 16 KB)
02AS001E
ADM-012-ADS-SIAdult Day Service InvoiceAging  
Adult Day Services  
Open Adult Day Services Monthly Report (.doc, 2 pp, 93 KB)Open Adult Day Services Monthly Report (.pdf, 2 pp, 196 KB)
02AS002E
ADS-MR-1Adult Day Services Monthly ReportAdult Day Services  
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 Adult Day Services Referral/Application (.doc, 3 pp, 715 KB)Open Adult Day Services Referral/Application (.pdf, 3 pp, 184 KB)Open Adult Day Services Referral/Application Instructions (.pdf, 1 pp, 13 KB)
02AS003E
ADS-RA-1Adult Day Services Referral/ApplicationAdult Day Services  
Aging  
Applications  
Open Affidavit of Child Support Payments Received (.doc, 3 pp, 1.2 MB)Open Affidavit of Child Support Payments Received (.pdf, 3 pp, 185 KB)
03EN002E
CSED-1-AAffidavit of Child Support Payments ReceivedChild Support  
Open Agency Certification Report (.doc, 2 pp, 691 KB)Open Agency Certification Report (.pdf, 2 pp, 171 KB)
07LC047E
OCC-047Agency Certification ReportChild Care Licensing  
Child 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 Alternative Compliance Request (.doc, 1 pp, 693 KB)Open Alternative Compliance Request (.pdf, 1 pp, 143 KB)
07LC061E
OCC-061Alternative Compliance RequestChild Care Licensing  
Open Annual Assessment (.doc, 10 pp, 584 KB)Open Annual Assessment (.pdf, 10 pp, 202 KB)
02AG005E
AG-025Annual AssessmentAging  
Open Application Data Sheet Instructions (.pdf, 1 pp, 25 KB)
11PE012E
P-012Application Data Sheet InstructionsApplications  
Open Application for Child Support Services (.doc, 18 pp, 1.5 MB)Open Application for Child Support Services (.pdf, 18 pp, 736 KB)
03EN001E
CSED-001Application for Child Support ServicesApplications  
Child Support  
Open Application for Child Welfare Child Care Benefits (.doc, 6 pp, 1.1 MB)Open Application for Child Welfare Child Care Benefits (.pdf, 6 pp, 300 KB)
04MP042E
N/AApplication for Child Welfare Child Care BenefitsApplications  
Child Care  
Child Welfare  
Open Application for Disaster Food Benefit Assistance (.doc, 1 pp, 167 KB)Open Application for Disaster Food Benefit Assistance (.pdf, 1 pp, 79 KB)
08FB030E
N/AApplication for Disaster Food Benefit AssistanceApplications  
Food Stamps  
Open Application for Employment (.doc, 4 pp, 758 KB)Open Application for Employment (.pdf, 4 pp, 208 KB)
11PE012E
P-12Application for EmploymentApplications  
Personnel  
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, 142 KB)
24ED001E
MSW-001Application for Master of Social Work StipendApplications  
Developmental Disabilities Council  
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 IApplications  
Developmental 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, 120 KB)
24YL002E
N/AApplication for Oklahoma Youth Leadership Forum (YLF), Part IIApplications  
Developmental 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 ParticipantsApplications  
Developmental Disabilities Council  
Open Application for Participation (.doc, 5 pp, 1.4 MB)Open Application for Participation (.pdf, 5 pp, 433 KB)
23CD004E
SNP-S-002Application for ParticipationApplications  
Commodities  
Open Application for Volunteer Service (.doc, 3 pp, 723 KB)Open Application for Volunteer Service (.pdf, 3 pp, 177 KB)
22VL005E
VOL-5Application for Volunteer ServiceApplications  
General Use  
Volunteerism  
Open Application Supplement (.doc, 2 pp, 903 KB)Open Application Supplement (.pdf, 2 pp, 224 KB)Open Application Supplement Instructions (.pdf, 1 pp, 13 KB)
11PE201E
P-1-DApplication SupplementApplications  
Open Application to Serve (.doc, 3 pp, 762 KB)Open Application to Serve (.pdf, 2 pp,308 KB)
24DC001E
ODDC-001Application to ServeApplications  
Developmental Disabilities Council  
Open Appointment Log (.pdf, 2 pp, 20 KB)Open Appointment Log Instructions (.pdf, 1 pp, 26 KB)
04FE010E
DCFS-EFC-006Appointment LogChild Welfare  
Emergency Foster Care  
Open Area Agency on Aging (AAA) Quarterly Report - A (.doc, 3 pp, 1.7 MB)Open Area Agency on Aging (AAA) Quarterly Report - A (.pdf, 3 pp, 472 KB)
02AG021E
SUOA-S-54-AArea Agency on Aging (AAA) Quarterly Report - AAging  
Open Area Agency on Aging (AAA) Quarterly Report (.doc, 3 pp, 1.1 MB)Open Area Agency on Aging (AAA) Quarterly Report (.pdf, 2 pp, 160 KB)
02AG020E
SUOA-S-054Area Agency on Aging (AAA) Quarterly ReportAging  
Open Area Agency Quarterly Summary of Program Income (.doc, 1 pp, 147 KB)
02AG027E
SUOA-S-084Area Agency Quarterly Summary of Program IncomeAging  
Open Assessment of Assets (.doc, 3 pp, 899 KB)Open Assessment of Assets (.pdf, 3 pp, 186 KB)
08MA011E
MA-011Assessment of AssetsMedical  
Open Audit Report Transmittal (.doc, 1 pp, 859 KB)Open Audit Report Transmittal (.pdf, 1 pp, 230 KB)
02AG026E
SUOA-S-081Audit Report TransmittalAging  
Open Authorization for Examination and Billing (.doc, 1 pp, 674 KB)Open Authorization for Examination and Billing (.pdf, 1 pp, 153 KB)Open Authorization for Examination and Billing Instructions (.pdf, 1 pp, 20 KB)
08MA016E
ABCDM-016Authorization for Examination and BillingMedical  
Open Authorization for Foster Parent Consent for Medical Services - Emergency Custody (.pdf, 1 pp, 27 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  
Emergency Foster Care  
Open Authorization for Foster Parent Consent for Medical Services (.pdf, 1 pp, 27 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  
Emergency Foster Care  
Open Authorization for Hospital Discharge (.doc, 1pp, 653 KB)Open Authorization for Hospital Discharge (.pdf, 1 pp. 25 KB)Open Authorization for Hospital Discharge Instructions (.pdf, 1 pp, 18 KB)
04FE008E
DCFS-EFC-005Authorization for Hospital DischargeChild Welfare  
Emergency Foster Care  
Open Authorization to Disclose Medical Records (.doc, 2 pp, 177 KB)Open Authorization to Disclose Medical Records (.pdf, 2 pp, 152 KB)Open Authorization to Disclose Medical Records Instructions (.pdf, 1 pp, 12 KB)
08HI003E
HIPAA-003Authorization to Disclose Medical RecordsHIPAA  
Open Automatic Deposit Transmittal (.doc, 2 pp, 880 KB)Open Automatic Deposit Transmittal (.pdf, 2 pp, 138 KB)
10OA073E
OPM-73Automatic Deposit TransmittalFinance  
Personnel  
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  
Emergency Foster Care  
Open Benefit Review Report (.doc, 7 pp, 1.1 MB)Open Benefit Review Report (.pdf, 7 pp, 378 KB)
08MP004E
FSS-BR-001Benefit Review ReportMultiple Programs  
Open Bodily Injury Chart (.pdf, 1 pp, 79 KB)
15IV002E
OCA-002Bodily Injury ChartClient Advocacy  
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 ApplicationApplications  
Child Welfare  
Open Capacity Assessment (.doc, 1 pp, 1.2 MB)Open Capacity Assessment (.pdf, 17 pp, 641 KB)
06MP032E
N/ACapacity AssessmentDevelopmental Disabilities  
Open Caretaker Conduct Review Report - Office of Juvenile Affairs (OJA) Operated Facility (.doc, 4 pp, 121 KB)Open Caretaker Conduct Review Report - Office of Juvenile Affairs (OJA) Operated Facility (.pdf, 3 pp, 149 KB)
15IV003E
OCA-007-ACaretaker Conduct Review Report - Office of Juvenile Affairs (OJA) Operated FacilityClient Advocacy  
Open Caretaker Conduct Review Report - OKDHS Operated Facility (.doc, 3 pp, 702 KB)
15IV007E
OCA-7Caretaker Conduct Review Report - OKDHS Operated FacilityClient Advocacy  
Open Caretaker Conduct Review Report - Residential Facilities (.doc, 3 pp, 120 KB)Open Caretaker Conduct Review Report - Residential Facilities (.pdf, 3 pp, 159 KB)
15IV009E
OCA-007-BCaretaker Conduct Review Report - Residential FacilitiesClient Advocacy  
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 Certification for Special Needs Child Care Rate (.doc, 5 pp, 626 KB)Open Certification for Special Needs Child Care Rate Instructions (.pdf, 2 pp, 23 KB)
08AD006E
ADM-123Certification for Special Needs Child Care RateChild Care  
Open Certification Program Repayment Agreement (.doc, 1 pp, 509 KB)Open Certification Program Repayment Agreement (.pdf, 1 pp, 53 KB)
05EA001E
N/ACertification Program Repayment AgreementPersonnel  
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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