You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
|
FAA-1506A | Statement of No Income (English) | 05/01/2023 |
|
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
|
CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
|
DDD-1678A | Home Modifications Service Assessment (English) | 05/01/2023 |
|
FAA-1494A | Authorized Representative Removal | 05/01/2023 |
|
GCI-1033A-S | Resumen de la Conferencia de Transición | 05/01/2023 |
|
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 05/01/2023 |
|
FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
|
GCI-1032A | IFSP Transition Meeting Invitation Prior Written Notice | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-1796A | Affidavit of Visually Viewed Documentation | 02/01/2021 |
|
RSA-1396A | Secure Email Waiver | 02/01/2021 |
|
UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
|
UB-010-S | Eligibility Review Questionnaire (Spanish) | 02/01/2021 |
|
DDD-2086A | Support Coordinator Screening and Discharge for Occupational, Physical, and Speech Therapy | 01/01/2021 |
|
DDD-2088A | Evaluation Report Plan of Care/Treatment: Certification/Recertification | 01/01/2021 |
|
LCR-1054A-S | Formulario de Solicitud Inicial | 01/01/2021 |
|
CSE-1315A | Federal Form - General Testimony | 01/01/2021 |
|
CSE-1315B | Federal Form - General Testimony Instructions | 01/01/2021 |
|
LCR-1086A | Application for Child Developmental Home Certification | 01/01/2021 |
Stay up-to-date with news and updates delivered straight to your inbox
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