You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1541A | ALTCS Enrollment Transition Information (ETI) (English) | 12/01/2022 |
|
UIT-1271A | A Guide to Unemployment Insurance Tax and Benefits (English) | 12/01/2022 |
|
CCA-0004A | Accident, Illness or Injury Report (Eng/Span) | 12/01/2022 |
|
CAP-1001A | Community Action Service Providers | 12/01/2022 |
|
CCA-0005A | Log of Accidents, Injuries or Illnesses (English/Spanish) | 12/01/2022 |
|
ESA-1184D | Veteran’s Priority of Service ID Card | 12/01/2022 |
|
CAP-1001A-S | Servicios de Acción Comunitaria | 12/01/2022 |
|
EAP-1004A-S | Applicant Statement of Tribal LIHEAP Denial (Spanish) | 12/01/2022 |
|
CCA-0036A | Permission to Give Medication | 12/01/2022 |
|
EAP-1004A | Applicant Statement of Tribal LIHEAP Denial (English) | 12/01/2022 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
RSA-1313A | Authorization for Release of RSA Records | 05/01/2018 |
|
RSA-1313A-S | Autorización de Divulgación de Registros de RSA | 05/01/2018 |
|
DDD-1404C | Employment Support Aide - Quality Assurance Review | 05/01/2018 |
|
PPP-1063A | HIPAA Privacy Complaints (English) | 05/01/2018 |
|
UB-296 | Report of Illness or Physical Disability (English) | 05/01/2018 |
|
UB-296-S | Report of Illness or Physical Disability (Spanish) | 05/01/2018 |
|
DDD-1403B | Individual Supported Employment - Six Month Report | 05/01/2018 |
|
PAU-592 | Data Disclosure Information and Fee Schedule | 04/01/2018 |
|
DDD-289 | Child Developmental Foster Home Agreement | 04/01/2018 |
|
ETA- 081A -S | Suplemento a la Solicitud para Solicitantes de DUA que Trabajan por Cuenta Propia | 04/01/2018 |
Stay up-to-date with news and updates delivered straight to your inbox
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