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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FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
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LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers | 02/01/2023 |
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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CSE-1225A | Caretakers Raising Children | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 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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CSE-1225A-S | Cuidadores que Crían Niños | 02/01/2023 |
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DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 02/01/2023 |
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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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DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
LCR-1034A | Criminal History Self Disclosure Affidavit (English) | 10/01/2019 |
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CCA-0218A | Sign-In/Sign-Out Record (English) | 10/01/2019 |
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CCA-0218B | Sign-In/Sign-Out Record (Extended Version) | 10/01/2019 |
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CCA-0218B-S | Registro de Entradas y Salidas (Versión extendida) | 10/01/2019 |
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GCI-1113A | Child Transfer Form | 10/01/2019 |
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RSA-1386A | BEP 8 Step Process | 09/01/2019 |
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CCA-1116A | Child Care Assistance Priority Waiting List Income Table | 09/01/2019 |
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RSA-1384A | BEP Job-Shadowing Evaluation | 09/01/2019 |
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DDD-1532A | Hardship Reduction Request (English) | 09/01/2019 |
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CSE-1007A-S | Encuesta de Satisfacción del Cliente | 09/01/2019 |
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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