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-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
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FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 05/01/2023 |
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FAA-1494A-SLP | Remoción de un(a) Representante Autorizado(a) (Letra Grande) | 05/01/2023 |
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GCI-1032A-S | Invitación a una Reunión de Transición del IFSP Notificación Previa por Escrito | 05/01/2023 |
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GCI-1037A | Public Education Agency (PEA) Notification/Referral | 05/01/2023 |
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FAA-1004A-SXLP | Designation of EBT Alternate Card Holder - Extra Large Print (Spanish) | 05/01/2023 |
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FAA-1546A | Sponsor Deeming Information | 05/01/2023 |
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DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
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CCA-1170AS | Petición para el Retiro o Terminación de Solicitud - Para Proveedores de Cuidado de Niños | 05/01/2023 |
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FAA-1494A-XLP | Authorized Representative Removal (Extra Large Print) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
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CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
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CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
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CCA-1186A | Authority to Release Information | 11/01/2021 |
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GCI-1098A | AzEIP Public Awareness Materials Order Form | 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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CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/Spanish) | 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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