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Members of the Public should utilize this form to request data
This form is used to submit Citizen Input to the County Board.
This form is used to apply for positions on Itasca County Committees/Commissions/Boards.
Public health intake form.
Form for case managers to fill out to request flex funds for a client
Medical provider only completes this reimbursement form.
Form used to close case management services.
online application for Housing support
vendor profile name
DHS Housing support agreement
Online application for case managers to request respite
Review form that can be filled out by the case manager to update the county on how the client is doing
Online form to submit referrals for children's mental health case management services.
online referral form for the Parent Support Outreach Program
Please fill out an application for an appointment with the Itasca County Health and Human Services Advisory Committee.
Group Residential Housing (GRH) supportive housing settings must have an approved habitability inspection. The habitability inspection...
Group Residential Housing (GRH) supportive housing settings must have an approved habitability inspection. The habitability inspection will determine whether the housing occupied by the GRH recipients meets the Department of Human Services’ habitability standards. Less…
form used for Housing Support billing (GRH)
Form used to open case management services.
Housing Support provider agreement
DHS form used to approve or deny funding
Housing supports for community settings.
a location for people to send questions about mandated reporting
Online form to submit referrals for adult mental health case management services.
Online form for reporting suspected child abuse/ neglect form
Eform used to send a referral in for a Rule 5 to establish if placement is needed in a Rule 5 facility
Wellness and Prevention Individual Health Appraisal Survey
Access the request for restitution and affidavit form.
Access the Adult Mental Health Referral form.