You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
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LCR-1084A-S | Solicitud de Renovación o Certificado de HCBS Modificado para Proveedores Independientes | 02/01/2023 |
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CSE-1225A-S | Cuidadores que Crían Niños | 02/01/2023 |
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DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
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DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 02/01/2023 |
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DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
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CCA-1216A | Notice to All Families Enrolled at DES Child Care Facility/Aviso A Todas Las Familias Inscritas En Una Instalación De Cuidado De Niños Del DES | 02/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1532A | Hardship Reduction Request (English) | 09/01/2019 |
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DDD-1532A-S | Hardship Reduction Request (Spanish) | 09/01/2019 |
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CSE-1007 | Customer Satisfaction Survey | 09/01/2019 |
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DDD-0403A | Reference Request (English) | 09/01/2019 |
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RSA-1383A | BEP Training - Applicant Checklist | 09/01/2019 |
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AAA-1122A | Host Agency Application | 08/01/2019 |
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UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
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DDD-1328B | Referral to Vocational Rehabilitation Packet (English) | 08/01/2019 |
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UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
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DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
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