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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
307 forms found    Page 1  2  3  4  5  6  7   
View Form No.Results shown in ascending orderLegacy No.Form Name Category
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  
Emergency Foster Care  
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 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  
Emergency Foster Care  
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  
Emergency Foster Care  
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  
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 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 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 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 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  
Open Request for Independent Living Youth Development Funds (.doc, 1 pp, 673 KB)Open Request for Independent Living Youth Development Funds (.pdf, 1 pp, 165 KB)Open Request for Independent Living Youth Development Funds Instructions (.pdf, 1 pp, 20 KB)
04IL006E
DCFS-84Request for Independent Living Youth Development FundsChild Welfare  
Open Request for Independent Living (IL) Service(s) - 18 to 21 (.doc, 1 pp, 671 KB)Open Request for Independent Living (IL) Service(s) – 18 to 21 Instructions (.pdf, 1 pp, 18 KB)
04IL007E
DCFS-85Request for Independent Living (IL) Service(s) – 18 to 21 Child Welfare  
Open Change in Placement Notification (.doc, 1 pp, 696 KB)Open Change in Placement Notification (.pdf, 1 pp, 137 KB)Open Change in Placement Notification Instructions (.pdf, 1 pp, 25 KB)
04KI025E
DCYFS-CWS-008AChange in Placement NotificationChild Welfare  
Open Safety Assessment - Oklahoma Childrens Services (OCS) Version (.doc, 3 pp, 712 KB)
04MP020E
DCFS-76-OCSSafety Assessment - Oklahoma Children's Services (OCS) VersionChild Welfare  
Open Child Welfare SoonerStart Referral (.doc, 2 pp, 678 KB)Open Child Welfare SoonerStart Referral (.pdf, 2 pp, 149 KB)
04MP021E
DCFS-121Child Welfare SoonerStart ReferralChild Welfare  
Open Referral for Contracted Services (.doc, 2 pp, 766 KB)Open Referral for Contracted Services (.pdf, 2 pp, 175 KB)
04MP032E
DCFS-108Referral for Contracted ServicesChild Welfare  
Open Child Welfare Referral for Substance Abuse Assessment and Treatment Services (.doc, 2 pp, 880 KB)Open Child Welfare Referral for Substance Abuse Assessment and Treatment Services (.pdf, 2 pp, 180 KB)
04MP033E
DCFS-98Child Welfare Referral for Substance Abuse Assessment and Treatment ServicesChild Welfare  
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 Letter to Verify Tribal Membership of Resource Family Applicants (.doc, 1 pp, 668 KB)Open Letter to Verify Tribal Membership of Resource Family Applicants Instructions (.pdf, 1 pp, 17 KB)
04TB001E
DCFS-58Letter to Verify Tribal Membership of Resource Family Applicants Child Welfare  
Open Personal Computer Donation Request (.doc, 1 pp, 676 KB)Open Personal Computer Donation Request (.pdf, 1 pp, 130 KB)
05AD003E
N/APersonal Computer Donation RequestData Services  
General Use  
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  
Open Remote Access Request and Authorization (.doc, 1 pp, 678 KB)
05SC001E
DSD-2Remote Access Request and AuthorizationComputer Access  
Data Services  
General Use  
Open Decentralized Access Control Security Agreement (.doc, 1 pp, 670 KB)Open Decentralized Access Control Security Agreement Instructions (.pdf, 1 pp, 17 KB)
05SC002E
DSD-3Decentralized Access Control Security Agreement Data Services  
General Use  
Computer Access  
Open OKDHS Logon Authorization Request for OKDHS Employees (.doc, 2 pp, 706 KB)Open OKDHS Logon Authorization Request for OKDHS Employees (.pdf, 2 pp, 196 KB)Open OKDHS Logon Authorization Request Instructions (.pdf, 2 pp, 21 KB)
05SC003E
MID-1OKDHS Logon Authorization Request Computer Access  
General Use  
Open Logon Authorization Request for Non-OKDHS Employees (.doc, 2 pp, 694 KB)Open Logon Authorization Request for Non-OKDHS Employees (.pdf, 2 pp, 144 KB)Open Logon Authorization Request for Non-OKDHS Employees Instructions (.pdf, 1 pp, 11 KB)
05SC004E
MID-1-ALogon Authorization Request for Non-OKDHS EmployeesData Services  
General Use  
Computer Access  
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 Residential Progress Report (.doc, 3 pp, 155 KB)Open Residential Progress Report (.pdf, 2 pp, 151 KB)
06CB062E
DDS-062Residential Progress ReportDevelopmental Disabilities  
Open Family Support Assistance Payment Services Application (.doc, 3 pp, 1318 KB)Open Family Support Assistance Payment Services Application (.pdf, 3 pp, 235 KB)
06DA031E
DDS-031Family Support Assistance Payment Services ApplicationApplications  
Developmental Disabilities  
Open Semi-annual Psychotropic Medication Review (.doc, 3 pp, 835 KB)Open Semi-annual Psychotropic Medication Review (.pdf, 3 pp, 154 KB)
06HM067E
DDS-67Semi-annual Psychotropic Medication ReviewDevelopmental Disabilities  
Open In-Home Supports Waiver - Certificate of Competency (.doc, 2 pp, 840 KB)Open In-Home Supports Waiver - Certificate of Competency (.pdf, 2 pp, 139 KB)
06IS037E
DDS-037In-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 Request for Developmental Disabilities Services (.doc, 5 pp, 1.1 MB)Open Request for Developmental Disabilities Services (.pdf, 5 pp, 277 KB)
06MP001E
DDS-1Request for Developmental Disabilities ServicesApplications  
Developmental 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, 813 KB)Open Guardianship, Advocacy, and Capacity Annual Review (.pdf, 1 pp, 154 KB)
06MP034E
N/AGuardianship, Advocacy, and Capacity Annual ReviewDevelopmental Disabilities  
Open Incident Report (.doc, 2 pp, 204 KB)Open Incident Report (.pdf, 2 pp, 247 KB)
06MP046E
DDS-046Incident ReportDevelopmental 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 (.doc, 3 pp, 1,471 KB)Open Monthly Attendance Record (.xls, 44 KB)
06WP044E
DDS-044Monthly 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 Staff Summary (.doc, 2 pp, 690 KB)Open Staff Summary (.pdf, 2 pp, 251 KB)
07LC002T
OCC-002Staff SummaryChild Care Licensing  
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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