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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 |
|---|---|---|
| GCI-1094A | Early Intervention Contact Log (English) | 11/01/2023 |
| GCI-1185A | Transition AzEIP Programmatic Meeting (English) | 11/01/2023 |
| DDD-2076A | DDD Health Plan Care Management Referral (English) | 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 |
| EAP-1006A-S | LIHEAP Portable Fuel Certification (Spanish) | 11/01/2023 |
| DDD-2255A | What to Do If You Have an Emergency (English/Spanish) | 11/01/2023 |
| DDD-2249A-S | Age 6 Redetermination Packet (Spanish) | 11/01/2023 |
| DDD-2256A | Support Coordination (English/Spanish) | 11/01/2023 |
| DDD-2250A-S | Age 18 Redetermination Packet (Spanish) | 11/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| CCA-1021A-S | Unpaid Co-payment Worksheet (Spanish) | 10/01/2022 |
| LCR-1005A | Notice of Inspection Rights (English) | 10/01/2022 |
| DDD-1991A-S | DDD Eligibility Checklist (Spanish) | 10/01/2022 |
| DDD-1991A | DDD Eligibility Checklist (English) | 10/01/2022 |
| GCI-1147A | Records Request Response (AzEIP) | 10/01/2022 |
| 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 |
| Number | Document Name | Effective Date |
|---|---|---|
| GCI-1102A-S | Evaluaciones de los Resultados de los Niños y las Familias - Accessible | 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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