Please email:, Eliot - Progress Notes: Hospitalizations/Surgeries, Core Competencies Client Specific Sheets, Performance Eval - ONA Represented Employee, Addendum to Physician Orders, Medication Administration Irregularities, Physician's Directions, Medical Home Support Service Assessment, Med. Admin. Original text. + '?List={ListId}&ID={ItemId}'), /_layouts/15/images/sendOtherLoc.gif?rev=40, javascript:GoToPage('{SiteUrl}' + These documents are available for use in any setting. List of expenses related to adoption submitted to the court and DHS. Most Requested Forms; Forms by Topic. The Governor's Advocacy Office assists thousands of individuals and families throughout Oregon every year, including any individual experiencing a problem with or seeking information about programs or services provided by DHS. + '?List={ListId}&ID={ItemId}'), Voluntary Adoption Registry Notification Sample Form, Genetic and Medical History of Child and Family (CF 246), Non-State Department of Human Services (CF 246A, Genetic/Medical History), Request for Oregon Criminal History Information, Request for FBI Criminal History Information, Private Agency and Independent Adoption Disruption/Dissolution Report, Notice of Right to Payment for Adoption-Related Counseling, Request for Waiver of Independent Adoption Fees Statement of Household Earnings, Waiver of Home Study/Placement Report Form and Instructions, a biological or adoptive parent retains parental rights or. Any DHS client or customer who believes they received poor customer service or were treated in a discriminatory manner may file a formal complaint. Learn more about the PDF software requirements. (Temporary Form) Necessary when petitioner is requesting a waiver of the home study requirement. The Department has the authority to waive an adoption home study when: javascript: SP.SOD.executeFunc('followingcommon.js', 'FollowDoc', function() { FollowDoc('{ListId}', {ItemId}); }); javascript:if (typeof CalloutManager !== 'undefined' && Boolean(CalloutManager) && Boolean(CalloutManager.closeAll)) CalloutManager.closeAll(); commonShowModalDialog('{SiteUrl}'+ STAFF TOOLS APD-Developmental Disabilities. petition. DHS Forms and Document Management. You can download the latest version of Adobe Acrobat Reader at. Per ORS 109.342, required for all adoptions, except step-parent adoption. Applies to adoptions that require a placement report. Provide to the court and DHS. The Office of Developmental Disability Services (ODDS) has published support documents in PDF format. Special focus is paid to highlight the person’s preferences on how to be supported and what the person does for him/herself around the issue. '/_layouts/15/Reporting.aspx' DHS provides free help. a petitioner qualifies as a relative as defined in Oregon Administrative Rules. BCU’S new background check system is going paperless! '/_layouts/15/itemexpiration.aspx' +'?ID={ItemId}&List={ListId}', 'center:1;dialogHeight:500px;dialogWidth:500px;resizable:yes;status:no;location:no;menubar:no;help:no', function GotoPageAfterClose(pageid){if(pageid == 'hold') {STSNavigate(unescape(decodeURI('{SiteUrl}'))+ GAO must adhere to Oregon statutes, administrative rules, department and program policies without exception. '/_layouts/15/Reporting.aspx' The Governor’s Advocacy Office (GAO) is an ombudsman office to help affected parties work through questions, concerns, or complaints related to Department of Human Services (DHS) services or action. manner may file a complaint with the Governor's Advocacy ​The following forms may be filed at the same time as a Non-Departmental adoption Please contact your local court if … Administrator and Children’s Ombudsman: Zachary Gehringer, Civil Rights, ADA and Formal Complaint Coordinator: Jason Wenig, Intake and Administrative Support: Wendy Leedle, Governor's Advocacy Office, DHS Ombudsman Program, Foster Care Ombudsman, Phone: (503) 945-6904Toll-free: 1-800-442-5238TTY number: 711Email : number: (503) 378-6532. Required for all adoptions. All of these support documents feature options to highly personalize them to each person’s unique support needs. Only for the use of private adoption agencies to report an adoption disruption or dissolution. DHS 0943 (10/19) page 3 of 5, Recycle prior versions If anyone’s income (other than from working) has changed or will change, please list below and attach proof. CBP Forms Instructions: Financial Plan instructions. Follow the instructions on the form to complete the DHS Client Complaint and Report of Discrimination form (see below), then: Email it directly to the GAO or; Contact your local DHS service office. How to locate a specific form. Some examples of the free help DHS can provide are: sign language and spoken language interpreters, written materials in other languages, Braille, large print, audio and other formats. Any DHS client or customer who believes they received poor customer service or were treated in a discriminatory manner may file a formal complaint. + '?List={ListId}&ID={ItemId}'), /_layouts/15/images/sendOtherLoc.gif?rev=40, javascript:GoToPage('{SiteUrl}' + Translated Forms. Admin. Page 3 of 8 MSC 0301 QED (11/2017) Instructions for this form are on pages 5–8.If not received, contact the agency where you are applying. If you have potentially disqualifying convictions or conditions, the BCU must consider several