You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
FAA-1565A-S | Acuerdo de Prueba de Drogas para recibir Asistencia Nutricional | 05/01/2023 |
FAA-0259A | Unwed Minor Parent Abuse/Neglect Claim | 05/01/2023 |
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
FAA-0259A-S | Denuncia de Abuso o Negligencia de un Padre Soltero que es Menor de Edad | 05/01/2023 |
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
J-930-A | Request for Modification/Accomodation to Participate in A Program, Service, or Activity (Confidential) (English) | 07/01/2020 |
OEO-1011A | One-Stop Centers Monitoring Checklist for ADA Compliance | 07/01/2020 |
CCA-0229A-FY21 | Child Care Assistance Gross Monthly Income Eligibility Chart And Fee Schedule FY 2021 (English/Spanish) | 07/01/2020 |
GCI-1085A | Vision Screening Checklist | 07/01/2020 |
RSA-1390A | Statement of Services Rendered | 07/01/2020 |
GCI-1042A | Family Survey | 07/01/2020 |
GCI-1085A-S | Lista de verificación para el examen de la visión | 07/01/2020 |
GCI-1042A-S | Encuesta Familiar | 07/01/2020 |
CSE-1185A | Affidavit of Credible Person Identifying Affiant (English/Spanish) | 07/01/2020 |
GCI-1084A | Hearing Screening Tracking (English) | 06/01/2020 |
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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