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-1249A | Verification of Disability | 05/01/2023 |
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GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
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FAA-0412A-SLP | Change Report - Large Print (Spanish) | 05/01/2023 |
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CCA-0221A | Family Child Care Provider Statement of Services | 05/01/2023 |
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DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
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Statistical Bulletin March 2023 | Statistical Bulletin March 2023 | 04/21/2023 |
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LIHEAP Plan FY23 | Low-Income Home Energy Assistance Program (LIHEAP) Plan | 04/19/2023 |
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CCA-1313A | Child Care Assistance for Full-Time Students | 04/01/2023 |
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UIB-1263A | Request for Overpayment Waiver (English) | 04/01/2023 |
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UIB-1263A-S | Request for Overpayment Waiver (Spanish) | 04/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-2093A | DDD Behavioral Health Advocate Referral | 03/01/2021 |
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DDD-2092A | DDD Behavioral Health Advocacy Plan | 03/01/2021 |
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DDD-2092A-S | Plan de Defensa de la Salud Conductual de la DDD | 03/01/2021 |
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UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
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UB-010-S | Eligibility Review Questionnaire (Spanish) | 02/01/2021 |
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DDD-2087A | Documentation Guidelines: Occupational, Physical, and Speech-Language Pathology Therapy Services | 02/01/2021 |
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FAA-1796A | Affidavit of Visually Viewed Documentation | 02/01/2021 |
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RSA-1298A | Referral Form (English) | 02/01/2021 |
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RSA-1396A | Secure Email Waiver | 02/01/2021 |
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RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
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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