You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1701A-LP | Verification of Terminated Employment - Large Print (English) | 05/01/2023 |
FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
FAA-1004A-S | Designation of EBT Alternate Card Holder (Spanish) | 05/01/2023 |
AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
FAA-0065A-XLP | Verification of Living Arrangements/Residential Address - Extra Large Print (English) | 05/01/2023 |
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
FAA-1494A-LP | Authorized Representative Removal (Large Print) | 05/01/2023 |
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
RSA-1298A-S | Referral Form (Spanish) | 02/01/2021 |
LCR-1087A | Child Developmental Certified Home Application Cover Page | 02/01/2021 |
RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
RSA-1298A-S-LP | Referral Form - Large Print (Spanish) | 02/01/2021 |
DDD-2087A | Documentation Guidelines: Occupational, Physical, and Speech-Language Pathology Therapy Services | 02/01/2021 |
CSE-1315A | Federal Form - General Testimony | 01/01/2021 |
CSE-1315B | Federal Form - General Testimony Instructions | 01/01/2021 |
LCR-1086A | Application for Child Developmental Home Certification | 01/01/2021 |
DDD-2086A | Support Coordinator Screening and Discharge for Occupational, Physical, and Speech Therapy | 01/01/2021 |
LCR-1054A-S | Formulario de Solicitud Inicial | 01/01/2021 |
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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