You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1818A-S | Deducción Estándar de Gastos Médicos de Asistencia Nutricional (NA) | 07/01/2023 |
FAA-1724A-S | Application Signature Pages (Spanish) | 07/01/2023 |
FAA-1415A-LP | Illegal Drug Use Statement - Large Print (English) | 07/01/2023 |
LCR-1041A-S | Voluntary Withdrawal of Application for Licensure or Voluntary Closure of License (Spanish) | 07/01/2023 |
PPP-1136A | Health Insurance Portability and Accountability Act of 1996 - Business Associate Agreement (English) | 07/01/2023 |
FAA-1724A-SLP | Application Signature Pages- Large Print (Spanish) | 07/01/2023 |
FAA-1724A-SXLP | Application Signature Pages- Extra Large Print (Spanish) | 07/01/2023 |
FAA-1513A-XLP | Time Savings Tips (Extra Large Print) | 07/01/2023 |
FAA-1714A | Mid Approval Contact - Lobby (English) | 07/01/2023 |
VR-12.2 | 12.2 Maintenance | 06/30/2023 |
Number | Document Name | Effective Date |
---|---|---|
RSA-1298A-S | Referral Form (Spanish) | 02/01/2021 |
RSA-1396A | Secure Email Waiver | 02/01/2021 |
RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
RSA-1298A-S-LP | Referral Form - Large Print (Spanish) | 02/01/2021 |
LCR-1087A | Child Developmental Certified Home Application Cover Page | 02/01/2021 |
UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
UB-010-S | Eligibility Review Questionnaire (Spanish) | 02/01/2021 |
DDD-2087A | Documentation Guidelines: Occupational, Physical, and Speech-Language Pathology Therapy Services (English) | 02/01/2021 |
CSE-1315A | Federal Form - General Testimony | 01/01/2021 |
CSE-1315B | Federal Form - General Testimony Instructions | 01/01/2021 |
Pursuant to Title VI of the Civil Rights Act of 1964, the Americans with Disabilities Act (ADA) and other nondiscrimination laws and authorities, ADES does not discriminate on the basis of race, color, national origin, sex, age, or disability. Persons that require a reasonable modification based on language or disability should submit a request as early as possible to ensure the State has an opportunity to address the modification. The process for requesting a reasonable modification can be found at Equal Opportunity and Reasonable Modification