You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
CCA-1197A-S | Plan de Preparación y Respuesta en Caso de una Emergencia para los Proveedores de Hogar Certificado para el Cuidado de Niños | 07/01/2023 |
FAA-0620D | Supplemental Pages for the Treatment Center Monthly Roster | 07/01/2023 |
CCA-1198A-S | Acuse de Recibo y Entendimiento | 07/01/2023 |
LCR-1041A | Voluntary Withdrawal of Application for Licensure or Voluntary Closure of License | 07/01/2023 |
LCR-1041A-S | Retiro Voluntario de la Solicitud de Licenciamiento o Cierre Voluntario de Licencia | 07/01/2023 |
FAA-1775A | How Do I File a Complaint (English/Spanish) | 07/01/2023 |
FAA-1819A | EBT Card Safety and Fraud Prevention | 07/01/2023 |
FAA-1724A-LP | Application Signature Pages - Large Print (English) | 07/01/2023 |
FAA-1415A | Illegal Drug Use Statement (English) | 07/01/2023 |
FAA-1415A-SLP | Illegal Drug Use Statement - Large Print (Spanish) | 07/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
CCA-0041A | Fair Hearing Request | 11/01/2021 |
CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
CCA-1186A | Authority to Release Information | 11/01/2021 |
SNA-1066A | Voluntary Participation Agreement (English) | 10/01/2021 |
DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
DDD-2101A-S | Electronic Visit Verification (EVV) Paper Timesheet Attestation (Spanish) | 09/01/2021 |
DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
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