You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1492A | Authorized Representatives - Rights & Responsibilities | 07/01/2023 |
CCA-1198A | Acknowledgement of Receipt and Understanding | 07/01/2023 |
CCA-0208A-S | Provider/Parent/Guardian's Agreement for Child Care Charges (Spanish) | 07/01/2023 |
FAA-1513A | Time Saving Tips | 07/01/2023 |
FAA-0620D | Supplemental Pages for the Treatment Center Monthly Roster | 07/01/2023 |
FAA-1819A | EBT Card Safety and Fraud Prevention | 07/01/2023 |
FAA-1513A-S | Consejos para Ahorrar Tiempo | 07/01/2023 |
FAA-1724A-LP | Application Signature Pages (Large Print) | 07/01/2023 |
LCR-1041A | Voluntary Withdrawal of Application for Licensure or Voluntary Closure of License | 07/01/2023 |
FAA-1415A-SLP | Illegal Drug Use Statement - Large Print (Spanish) | 07/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
HRP-1053A | CSFP Annual Agreement- CHRP/RFB | 06/01/2022 |
GCI-1046A | Referral Letter (English) | 06/01/2022 |
GCI-1046A-S | Referral Letter (Spanish) | 06/01/2022 |
GCI-1034A | Records Released Log | 06/01/2022 |
CCA-1207A | Notice of Monitoring Rights - Disclosure Verification | 06/01/2022 |
CCA-1271A | Service Consent Form (English) | 06/01/2022 |
DDD-2039A | HCBS Member Needs Assessment | 05/01/2022 |
UIA-1057A | Arizona Unemployment Insurance Basic Information (English) | 05/01/2022 |
UB-195-FF | Affidavit as to Forged Endorsement | 05/01/2022 |
DDD-2039A-S | HCBS Member Needs Assessment (Spanish) | 05/01/2022 |
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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