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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CCA-1175A | Landlord Permission to Provide Family Child Care Service | 05/01/2023 |
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FAA-1494A-LP | Authorized Representative Removal (Large Print) | 05/01/2023 |
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GCI-1033A-S | Resumen de la Conferencia de Transición | 05/01/2023 |
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FAA-1799A | Drug/Alcohol Treatment Center Training Acknowledgment | 05/01/2023 |
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FAA-0412A-SLP | Change Report - Large Print (Spanish) | 05/01/2023 |
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FAA-1249A | Verification of Disability | 05/01/2023 |
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CCA-0221A | Family Child Care Provider Statement of Services | 05/01/2023 |
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FAA-0412A-S | Change Report (Spanish) | 05/01/2023 |
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FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
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FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-1235A | CCA Change Report | 11/01/2021 |
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CCA-1235A-S | CCA Informe de Cambios | 11/01/2021 |
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CCA-1186A | Authority to Release Information | 11/01/2021 |
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CCA-0041A | Fair Hearing Request | 11/01/2021 |
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CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
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CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
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CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
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DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
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SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
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DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
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