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A list of forms used in the SMF application process appears below. They can be accessed at:
DSS-6187 Application for State Maternity Funds (Agency and Applicant Information, Problem Assessment and Service Plan, Certification and Signature of Applicant and Caseworker, Instructions to Complete Application, Rev 10-06)
DSS-6188 Notice of Action on Request for State Maternity Fund
(Rev. 10-06)
DSS-6189 State Maternity Fund Residential Care Provider Agreement
(Rev. 05-05)
DSS-6211 State Abortion Fund Eligibility Certification (Rev. 05-06)
DSS-6212 State Abortion Fund Client Statement (Rev. 10-06)
DSS-6847 State Abortion Fund Authorization (Rev. 05-06)
DSS-5278 Request for Placement Evaluation For Infant Born to an Incarcerated Mother
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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