You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-2121A-S | Person-Centered Service Plan Supplement to the Individualized Family Service Plan (Spanish) | 03/01/2024 |
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DDD-2131B | Volunteers Needed/ Necesitan Voluntarios | 05/01/2023 |
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DDD-2149A | Authorization to Release Records | 08/01/2022 |
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DDD-2153A | Likely Eligibility Tool (LET) | 03/01/2023 |
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DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
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DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-2176A | Residency Agreement (English) | 03/01/2023 |
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DDD-2176A-S | Residency Agreement (Spanish) | 03/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
RRP-1017A | Program Participants Application for Recertification (English) | 11/01/2023 |
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RRP-1017A-S | Program Participants Application for Recertification (Spanish) | 11/01/2023 |
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RRP-1018A | Client Employment & Income Attestation Form (English) | 11/01/2023 |
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RRP-1018A-S | Client Employment & Income Attestation Form (Spanish) | 11/01/2023 |
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RSA-1213A-SLP | Autorización para Divulgación de Información de Salud a RSA (Letra Grande) | 09/01/2022 |
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RSA-1298A | Referral Form (English) | 02/01/2021 |
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RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
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RSA-1298A-S | Referral Form (Spanish) | 02/01/2021 |
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RSA-1298A-S-LP | Referral Form - Large Print (Spanish) | 02/01/2021 |
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RSA-1298B | Blind/Visually Impaired Deaf/Hard of Hearing Summer Youth Program Referral | 01/01/2023 |
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