External Provider Resources - Contacts & Forms
Provider Contacts
- AHRMS Providers-DHS
- Domestic Violence Resources
- FAS-ES Liaison Contacts 9.2024
- RC Employment Services Providers 6/2024
- Food Shelves in Ramsey County
CLUES Partners for Equity Program Information
- CLUES PE Process 10/2024
- CLUES PE Referral Form 9/2024
- CLUES PE Activities
- CLUES Trainings
- WF1 User Guide - CLUES Partners for Equity
Documents & Forms
Lifelong Learning Initiative Tools & Process - Ramsey County
DWP/MFIP Forms - Ramsey County
- 48+Interview - 4/7/2017 (optional form)
- 90 Day ES Training Guide Packet - 7/28/2017
- Invoice and Budget Modification Form
- Authorization to Communicate Through Email and Texting
- Case Transfer Form revised 3/18/2020
- Child Care Transmittal
- Child under 12 month exemption sample letter
- DHS Systems Request Access Form 7/30/24
- Education Training Guide 5/2024 ; Education Training Counselor Checklist. 5/2024
- Extension Decision Form 9/2024
- Extension Quick Reference for LF and Case Note 12/2019
- Face to Face Extension Checklist
- FSS Eligibility Screening Form 8/2024
- Request for Medical Information
- Request for Medical Opinion - Family Member
- Request for Medical Opinion - Participant
- Request for Medical Opinion - Serious and Persistent Mental Illness
- Request for Medical Opinion - Severe Emotional Disturbance
- Request for Medical Opinion - Temporarily Unemployable Participant
- WF1 User Access Request Form - MFIP DWP 8/29/23
DWP/MFIP Forms - MN DHS
- Authorization for Release of Employment Information (2146)
- Brief Screening Tool for Special Learning Needs (3504)
- DWP/MFIP Observation Checklist (3483)
- Employability Measure; EM User Guide
- MFIP Education Activity Log (DHS-4209N)
- Employment Services Responsibilities, Rights and Consent (3172)
- Family Stabilization Sanction Checklist - June 2016 (docx)
- Family Stabilization Services Sample Medical Cover Letter (5285)
- Family Violence Referral (3323)
- Household Report(2120) updated - Sept. 2017
- MFIP/DWP Employment Plan Case Information (4209)
- MFIP/DWP Employment Plan - Child Care or Transportation (4209H)
- MFIP/DWP Employment Plan - County/State Social Services (4209M)
- MFIP/DWP Employment Plan - Education (4209D)
- MFIP/DWP Employment Plan - Employment (4209A)
- MFIP/DWP Employment Plan - Family Safety (4209E)
- MFIP/DWP Employment Plan - Health (4209I)
- MFIP/DWP Employment Plan - Housing (4209J)
- MFIP/DWP Employment Plan - Job Search Requirements (4209B)
- MFIP/DWP Employment Plan - Legal Issues (4209L)
- MFIP/DWP Employment Plan - Personal/Family Activity (4209K)
- MFIP/DWP Employment Plan - Unpaid Work Activities (4209C)
- MFIP/DWP ES Weekly Job Search Activity Log (5784)
- MFIP ES Authorization to Release of Information (4093)
- MFIP Notice of Intent to Sanction (3175)
- MFIP Self-Screen (3482)
- MFIP Self-Screen Scoring Form (3482A)
- Minnesota Child Care Assistance Program Application (3550)
- Notice of Privacy Practices (3979)
- Notice of Requirement to Attend MFIP Overview (2929)
- Request for Verification of School Attendance/Progress (2883)