Department of Human Services

Official Website: https://www.dhs.pa.gov/

Their mission is to assist Pennsylvanians in leading safe, healthy, and productive lives through equitable, trauma-informed, and outcome-focused services while being an accountable steward of commonwealth resources.

Forms & Documents

Browse all Department of Human Services government forms

1 - 20 of 338 forms

Form Title Topics
1150 Administrative Waiver Request Personal Care Home, Order Medical Assistance
2600 - Entrance Conference Guide Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Abortion Consent Personal Care Home, Order Medical Assistance
Acne Agents, Topical Form Personal Care Home, Pharmacy Services Fax
Actemra Form Personal Care Home, Pharmacy Services Fax
Addendum C To Resident-Home Contract - Rent Rebates Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Adult Residential Licensing - Cash Distribution Record Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Adult Residential Licensing - Fire Drill Record Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Adult Residential Licensing - Quarterly Financial Summary Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Adult Residential Licensing - Record of Financial Transactions Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Adult Residential Licensing - Record of Training Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Adult Residential Licensing - Resident-Home Agreement Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Adult Residential Licensing - Staff Training Plan Personal Care Home, Personal Care Home Sample Model, PERSONAL CARE HOME SAMPLE MODEL
Affidavit Attesting to Citizenship Personal Care Home, Order Medical Assistance
Affidavit Attesting to Identity of Minor Child Personal Care Home, Order Medical Assistance
Affidavit Attesting to Unavailability of Documentary Evidence of Citizenship Personal Care Home, Order Medical Assistance
Aftercare Plan Summary and Discharge Form Personal Care Home, Mental Health Provider
Aliskiren Agents Form Personal Care Home, Pharmacy Services Fax
Alpha-1 Proteinase Inhibitors Form Personal Care Home, Pharmacy Services Fax
Alzheimer's Agents Form Personal Care Home, Pharmacy Services Fax

Contact Information & Office Locations

All 11 contact points

Allentown Office

Address:
555 Union Blvd
Allentown, PA 18109-3389

Phone numbers:
  • (610) 861-2000
Emails:
  • RA-RV-BET-BET-DO-EM@pa.gov

Erie Office

Address:
448 W 11th st
Erie, PA 16501-1501

Phone numbers:
  • (814) 871-4491
Emails:
  • v

Greensburg Office

Address:
Second Floor
15 W Third st
Greensburg, 15601-3003

Phone numbers:
  • (724) 832-5283
Emails:
  • RA-RV-BET-GBG-DO-EM@pa.gov

Harrisburg Office

Address:
Lobby
Strawberry sq
Harrisburg, PA 17128-0101

Phone numbers:
  • (717) 783-1405
Emails:
  • RA-RV-BET-HBG-TA-EM@pa.gov

Norristown Office

Address:
Second fl ste 210
Stony Creek Office Center
151 W Marshall St
Norristown, PA 19401-4739

Phone numbers:
  • (610) 270-1780
Emails:
  • RA-RV-BET-NOR-DO-EM@pa.gov

Philadelphia - Center City Office

Address:
STE 204A (Inheritance Tax Office in Suite 204B)
110 N 8TH ST
Philadelphia, PA 19107-2412

Phone numbers:
  • (215) 560-2056
Emails:
  • RA-RV-BET-PHI-TA-EM@pa.gov

Philadelphia - Northeast Office

Address:
ACDMY PLZ Shpg Ctr
3240 Red Lion rd
Philadelphia, 19114-1109

Phone numbers:
  • (215) 821-1860
Emails:
  • RA-RV-BET-PNE-DO-EM@pa.gov

Pittsburgh - Downtown Office

Address:
411 7th Ave room 420
Pittsburgh, PA 15219-1905

Phone numbers:
  • (412) 565-7540
Emails:
  • RA-RV-BET-PGH-TA-EM@pa.gov

Pittsburgh - Greentree Office

Address:
11 Parkway Ctr ste 175
Pittsburgh, PA 15220

Phone numbers:
  • (412) 929-0614
Emails:
  • RA-RV-BET-GTR-DO-EM@pa.gov

Reading Office

Address:
STE 239
625 Cherry St
Reading, PA 19602-1186

Phone numbers:
  • (610) 378-4401
Emails:
  • RA-RV-BET-RDG-DO-EM@pa.gov

Scranton Office

Address:
Bank Towers
207 Wyoming Ave
Room 207
Scranton, PA 18503-1427

Phone numbers:
  • (570) 963-4585
Emails:
  • RA-RV-BET-SCR-DO-EM@pa.gov

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