You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
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FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
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DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 02/01/2023 |
|
DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
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LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers | 02/01/2023 |
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WIO-1108A | WIOA EO Monitoring Review Guide | 02/01/2023 |
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RSA-1322A | Pre-Employment Transition Services | 02/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1328B | Referral to Vocational Rehabilitation Packet (English) | 08/01/2019 |
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RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
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DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
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DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
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UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
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AAA-1122A | Host Agency Application | 08/01/2019 |
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LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights | 07/01/2019 |
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GCI-1049A | No Contact Letter | 07/01/2019 |
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LCR-1007A-S | Informe de Visita al Hogar Suplemento Al Aviso de Derechos De Inspección y Debido Proceso | 07/01/2019 |
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RSA-1312A | Authorization for Disclosure of Health Information to RSA | 07/01/2019 |
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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