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This document outlines the regulations and requirements for conducting background checks on caregivers involved in programs regulated by the Department of Health Services and the Department of Children
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How to fill out DHS 12.03

01
Obtain the DHS 12.03 form from the official website or your local DHS office.
02
Read the instructions carefully before starting to fill out the form.
03
Begin with section A: enter your personal identification information, including your name and address.
04
Move on to section B: provide details about your situation and why you need assistance.
05
In section C, include any relevant documentation or proof to support your claims.
06
Review the completed form for accuracy and completeness.
07
Sign and date the form at the designated section.
08
Submit the form to the appropriate DHS office either in person or via mail.

Who needs DHS 12.03?

01
Individuals seeking assistance from the Department of Human Services.
02
Families in need of financial support or social services.
03
Persons requesting services related to food, housing, or healthcare assistance.
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DHS 12.03 is a specific form used by the Department of Human Services (DHS) for reporting various activities or compliance related to public aid.
Individuals or organizations that are receiving or managing public aid funds, or those involved in programs regulated by the DHS are required to file DHS 12.03.
To fill out DHS 12.03, collect the necessary information related to the applicable reporting period, complete each section of the form accurately, and follow the instructions provided for submission.
The purpose of DHS 12.03 is to ensure accountability and transparency in the management of public aid resources, and to track compliance with applicable regulations.
The information that must be reported on DHS 12.03 includes details about the recipient of aid, the amount of aid provided, program participation details, and any other relevant compliance information.
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