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Documents Center
Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Find a Document
- Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down.
- Type in a number or keyword in the "Search by Name, Number, or Keyword" box and click the Search button. When searching for a document by the exact title (form name), place the title within quotation marks.
- You can click on the column headers to sort the search results.
| Number | Document Name | Effective Date |
|---|---|---|
| DDD-2250A-S | Age 18 Redetermination Packet (Spanish) | 11/01/2023 |
| DDD-2258A | What is "DDD Eligibility Redetermination"? (English/Spanish) | 11/01/2023 |
| DDD-2254A | DDD Eligibility for Ages 6 to Adult (English/Spanish) | 11/01/2023 |
| RRP-1017A-S | Program Participants Application for Recertification (Spanish) | 11/01/2023 |
| DDD-2255A | What to Do If You Have an Emergency (English/Spanish) | 11/01/2023 |
| EAP-1006A-S | LIHEAP Portable Fuel Certification (Spanish) | 11/01/2023 |
| RRP-1018A-S | Client Employment & Income Attestation Form (Spanish) | 11/01/2023 |
| EAP-1006A | LIHEAP Portable Fuel Certification (English) | 11/01/2023 |
| DDD-2256A | Support Coordination (English/Spanish) | 11/01/2023 |
| UB-106-T-I | Completion Instructions for Approved Training Continued Claim, UB-106-T (English) | 11/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| CCA-0048A | Non-Certified Relative Provider Billing Report | 10/01/2022 |
| CCA-0031A | Verbal Notice of Eligibility (English/Spanish) | 10/01/2022 |
| CCA-0048A-S | Informe de Facturación de Proveedores Parientes no Certificados | 10/01/2022 |
| LCR-1005A-S | Notice of Inspection Rights (Spanish) | 10/01/2022 |
| LCR-1054A-S | Initial Application Worksheet (Spanish) | 10/01/2022 |
| DDD-1747A-S | Assisted Living Facility (ALF) Residential Facility (Spanish) | 10/01/2022 |
| LCR-1054A | Initial Application Worksheet (English) | 10/01/2022 |
| CCA-1021A | Unpaid Co-payment Worksheet (English) | 10/01/2022 |
| DDD-1991A-S | DDD Eligibility Checklist (Spanish) | 10/01/2022 |
| CCA-1021A-S | Unpaid Co-payment Worksheet (Spanish) | 10/01/2022 |
| Number | Document Name | Effective Date |
|---|---|---|
| DDD-1836A | Safety Information Fact Sheet #6 | 06/01/2017 |
| DDD-1807ACRD | Volunteer with a Human Rights Committee (Card) | 03/01/2017 |
| DDD-1807ACRD-S | Volunteer with a Human Rights Committee (Card Spanish) | 03/01/2017 |
| DDD-1795APAMPD | Dental Care Adult (Ages 21+) (English) | 12/01/2016 |
| DDD-1795APAMS | Dental Care Adult (Ages 21+) (Spanish) | 12/01/2016 |
| DDD-1751A | Responsible Driving Information Fact Sheet#6 (English) | 07/01/2016 |
| UIB-1220A | The Following Information is Required to File a New Application | 06/01/2016 |
| DDD-1745A-S | Vehicle Safety Buckle Up - Q&A's (Spanish) | 06/01/2016 |
| DDD-1745A | Vehicle Safety Buckle Up - Q&A's (English) | 05/01/2016 |
| UIB-1219B | How to File Your Weekly Claim (Bilingual) | 04/01/2016 |
Arizona State Resources
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
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