Skip to main content

Arkansas Department of Human Services

Go Search
Home
ARWorks Information
Child Fatality Notification
CHRIS Public
DHS Policy
DYS Staff Development
Rx Campaign
  
Arkansas Department of Human Services > DHS Forms  

DHS Forms

Modify settings and columns
  
View: 
Form DescriptionFilter
APS-0001.docAPS-0001AASAPS-0001 Request for Adult Maltreatment Registry Information
Request for Adult Maltreatment Registry Information - MS Word document with some interactive form fields
NoNo1/1/2016
DCO-0152 Spanish.pdfDCO-0152 SpanishDCODCO-0152 Spanish
DCO-0152 Spanish, Application for Health Coverage ~ SOLICITUD DE COBERTURA DE SALUD
NoYes11/1/2015
DCO-0152.pdfDCO-0152DCODCO-0152
DCO-0152, Application for Health Coverage
NoNo11/1/2015
DCO-0777.pdfDCO-0777DCODHS-0777
DHS-0777, Long Term Care Medicaid Application for Assistance (with Voter Registration)
NoNo1/1/2016
DDS-5088.pdfDDS-5088DDSDDS-5088 Request for Criminal Background Check
DDS Specific Form - Request for Criminal Background Check
NoNo1/4/2016
DHS-0777 Spanish.pdfDHS-0777 SpanishDCODHS-0777
DHS-0777 Spanish, Long Term Care Medicaid Application for Assistance (with Voter Registration) ~ SOLICITUD PARA ASISTENCIA DE CUIDADO A LARGO PLAZO
YesYes1/1/2015
DHS-2808.docxDHS-2808DHSDHS-2808, Complaint of Employment Discrimination
DHS-2808 is to be completed by the person filing a discrimination complaint and should be submitted no more than 180 days from the date of the alleged action. MS Word document with online fillable form fields.
YesNo8/30/2011