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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 |
|---|---|---|
| PPP-1136A | Health Insurance Portability and Accountability Act of 1996 - Business Associate Agreement (English) | 07/01/2023 |
| LCR-1041A-S | Voluntary Withdrawal of Application for Licensure or Voluntary Closure of License (Spanish) | 07/01/2023 |
| CCA-1176A | Parent/Guardian Affidavit of Non-Compensated Child Care (English) | 07/01/2023 |
| FAA-1182A | AHCCCS Fraud Prevention Determination Authorization | 07/01/2023 |
| CCA-1176A-S | Parent/Guardian Affidavit of Non-Compensated Child Care (Spanish) | 07/01/2023 |
| GCI-1163A | FFY 2021 Correction of NonCompliance Guidance (English) | 07/01/2023 |
| FAA-1724A-LP | Application Signature Pages - Large Print (English) | 07/01/2023 |
| FAA-1714A | Mid Approval Contact - Lobby (English) | 07/01/2023 |
| FAA-1415A | Illegal Drug Use Statement (English) | 07/01/2023 |
| VR-12.2 | 12.2 Maintenance | 06/30/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| 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 (English) | 02/01/2021 |
| UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
| UB-010-S | Eligibility Review Questionnaire (Spanish) | 02/01/2021 |
| FAA-1796A | Affidavit of Visually Viewed Documentation | 02/01/2021 |
| RSA-1396A | Secure Email Waiver | 02/01/2021 |
| DDD-2086A | Support Coordinator Screening and Discharge for Occupational, Physical, and Speech Therapy (English) | 01/01/2021 |
| DDD-2088A | Evaluation Report Plan of Care/Treatment: Certification/Recertification | 01/01/2021 |
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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