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
 
 
DHS Forms

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Formas

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Other Form Links

 

 

Harmony Access Request for Non-DHS Employees5989/16/2020 3:21:35 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx11289930http://www.okdhs.org9/16/2020 3:21:35 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Section 5310 Capital Assistance Vehicle Application7442/19/2019 11:54:10 AMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org2/19/2019 11:54:10 AMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
ACES$ Oklahoma Employee Pay Rate Sheet10061/30/2019 9:34:49 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx371730http://www.okdhs.org1/30/2019 9:34:49 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Conflict of Interest Standards230485/4/2020 4:51:36 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx7540http://www.okdhs.org5/4/2020 4:51:36 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Harmony Provider Agency Memorandum of Understanding (MOU)230495/5/2020 11:49:47 AMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx13170http://www.okdhs.org5/5/2020 11:49:47 AMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Request for Title XIX Nursing Assessment23050View, complete, or print the Oklahoma Department of Human Services (OKDHS), Form 02AG001E (ABCDM-83-A), Request for Title XIX Nursing Assessment1/24/2007 6:13:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx1704110http://www.okdhs.org1/24/2007 6:13:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Request for Title XIX Nursing Assessment2305110/9/2007 10:02:29 AMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx29593110http://www.okdhs.org10/9/2007 10:02:29 AMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Please update any information below that has changed since last year's Older American Act Assessment.23052View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG004E (AG-2-B), Change of Client Status.1/17/2008 8:24:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org1/17/2008 8:24:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Change of Client Status2305312/5/2010 2:32:27 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx2623640http://www.okdhs.org12/5/2010 2:32:27 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Change of Client Status Instructions230545/21/2008 4:01:57 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx2530700http://www.okdhs.org5/21/2008 4:01:57 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Area Agency on Aging (AAA)23055View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG005E (AG-25), Annual Assessment.1/17/2008 8:23:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org1/17/2008 8:23:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Annual Assessment2305612/5/2010 2:32:27 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx2731200http://www.okdhs.org12/5/2010 2:32:27 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Voluntary Withdrawal of Title III Project23057View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG006E (AG-29), Voluntary Withdrawal of Title III Project 1/17/2008 6:07:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org1/17/2008 6:07:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Voluntary Withdrawal of Title III Project2305812/5/2010 2:32:28 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx2348500http://www.okdhs.org12/5/2010 2:32:28 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Cash Disbursements Journal23059View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG011E (SUOA-S-10), Cash Disbursements Journal4/7/2010 2:23:35 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org4/7/2010 2:23:35 PMxlsFalsexls3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Cash Disbursements Journal23060View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG012E (SUOA-S-11), Cash Disbursements Journal3/23/2010 8:20:02 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org3/23/2010 8:20:02 PMxlsFalsexls3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Equipment Inventory23061View, complete, or print the Oklahoma Department of Human Services (OKDHS), Form 02AG013E (SUOA-S-16), Equipment Inventory8/9/2007 1:44:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx1527100http://www.okdhs.org8/9/2007 1:44:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Equipment Inventory2306212/5/2010 2:32:29 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx2301480http://www.okdhs.org12/5/2010 2:32:29 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
In-Kind Travel Expense Voucher23063View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG014E (SUOA-S-17), In-kind Travel Expense Voucher1/17/2007 9:38:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx56830http://www.okdhs.org1/17/2007 9:38:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
In-Kind Travel Expense Voucher2306412/5/2010 2:32:29 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org12/5/2010 2:32:29 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Organization Financial Report23065View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG015E (SUOA-S-20), Organization Financial Report3/25/2010 4:40:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org3/25/2010 4:40:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Organization Financial Report230663/25/2010 11:00:10 AMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx2188700http://www.okdhs.org3/25/2010 11:00:10 AMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Organization Financial Report Instructions230673/25/2010 11:01:04 AMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx2359630http://www.okdhs.org3/25/2010 11:01:04 AMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js
Nutrition Project Attendance Form23068View, complete, or print the Oklahoma Department of Human Services (OKDHS) Form 02AG016E (SUOA-S-32), Nutrition Project Attendance Form 1/17/2008 6:21:00 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx50400http://www.okdhs.org1/17/2008 6:21:00 PMdocFalsedoc3232~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormWord.js
Nutrition Project Attendance Form2306912/5/2010 2:32:30 PMSTS_ListItem_DocumentLibraryhttp://www.okdhs.org/OKDHS Form Library/Forms/AllItems.aspx0http://www.okdhs.org12/5/2010 2:32:30 PMpdfFalsepdf3131~sitecollection/_catalogs/masterpage/Display Templates/Search/Item_InternetFormPDF.js

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 WE IMPROVE THE QUALITY OF LIFE OF VULNERABLE OKLAHOMANS BY INCREASING THIER ABILITY TO LEAD SAFER, HEALTHIER, MORE INDEPENDENT AND PRODUCTIVE LIVES