You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
|
FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
|
FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
|
GCI-1037A | Public Education Agency (PEA) Notification/Referral | 05/01/2023 |
|
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
|
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
|
CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
|
FAA-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
|
FAA-1004A-SLP | Designation of EBT Alternate Card Holder - Large Print (Spanish) | 05/01/2023 |
|
GCI-1037A-S | Aviso o Recomendación de la Agencia de Educación Pública (PEA) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-0041A | Fair Hearing Request | 11/01/2021 |
|
CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
|
GCI-1098A | AzEIP Public Awareness Materials Order Form | 11/01/2021 |
|
CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
|
CCA-0024A | Employment and Wage Verification Statement (English) | 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 | 10/01/2021 |
|
DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
|
DDD-2102A | Electronic Visit Verification (EVV) Designee Attestation (English) | 09/01/2021 |
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