You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
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FAA-1506A | Statement of No Income (English) | 05/01/2023 |
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FAA-1004A-S | Designation of EBT Alternate Card Holder (Spanish) | 05/01/2023 |
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FAA-1546A | Sponsor Deeming Information | 05/01/2023 |
|
FAA-1565A-S | Acuerdo de Prueba de Drogas para recibir Asistencia Nutricional | 05/01/2023 |
|
FAA-1565A | Nutrition Assistance Drug Testing Agreement | 05/01/2023 |
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CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
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AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
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FAA-1546A-S | Información de Determinar a un Patrocinador | 05/01/2023 |
|
CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1984A | Behavior Plan / Packet Requirements (English) | 11/01/2021 |
|
DDD-1984A-S | Behavior Plan / Packet Requirements (Spanish) | 11/01/2021 |
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CCA-0024A | Employment and Wage Verification Statement (English) | 11/01/2021 |
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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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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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CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
|
CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
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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