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-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
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FAA-1494A | Authorized Representative Removal | 05/01/2023 |
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FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 05/01/2023 |
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GCI-1032A | IFSP Transition Meeting Invitation Prior Written Notice | 05/01/2023 |
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FAA-1768A | Overpayment Compromise Request Form | 05/01/2023 |
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CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
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DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
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FAA-1799A | Drug/Alcohol Treatment Center Training Acknowledgment | 05/01/2023 |
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FAA-0412A-S | Change Report (Spanish) | 05/01/2023 |
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FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
GCI-1098A | AzEIP Public Awareness Materials Order Form | 11/01/2021 |
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DDD-1984A | Behavior Plan / Packet Requirements (English) | 11/01/2021 |
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DDD-1984A-S | Behavior Plan / Packet Requirements (Spanish) | 11/01/2021 |
|
SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
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DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
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LCR-1079A | Developmental Home Compliance Review | 09/01/2021 |
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DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
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DDD-2099A-S | Plan de contingencia/respaldo del miembro para la verificación de visita electrónica (EVV) | 09/01/2021 |
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DDD-2100A-S | Hoja de horas de verificación de visita electrónica de DDD | 09/01/2021 |
|
CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
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