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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CCA-1164A-S | Affidavit of Immunization Exemption - For Children in Care (Spanish) | 05/01/2023 |
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DDD-2203A | Daily Shift Log (English) | 05/01/2023 |
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FAA-0412A-XLP | Change Report - Extra Large Print (English) | 05/01/2023 |
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FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
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FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
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FAA-1765A | Authority to Release Information | 05/01/2023 |
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FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
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DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
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CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
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GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
Download | Number | Name | Effective Date |
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FAA-1828A | Provider Determination | 08/01/2022 |
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HRP-1032A | Commodity Senior Food Program (CSFP) Informal Dispute Resolution Meeting / Fair Hearing Request | 08/01/2022 |
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RSA-1382A | BEP Memo | 08/01/2022 |
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GCI-1147B | Records Request Response (Contractors) | 08/01/2022 |
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CCA-0231A-2022 | Child Care Assistance Unwed Minor Parent Deeming Worksheet | 07/01/2022 |
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HRP-1015A | Annual Civil Rights Training (English) | 07/01/2022 |
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UIB-0101C | Work Search Plan of Action Affidavit (English) | 07/01/2022 |
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HRP-1016A | Volunteer Confidentiality | 07/01/2022 |
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HRP-1016A-S | Confidencialidad del Voluntario | 07/01/2022 |
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HRP-1033A | Commodity Senior Food Program (CSFP) ID/Transfer Card (English/Spanish) | 07/01/2022 |
Download | Number | Name | Effective Date |
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DDD-1745A | Vehicle Safety Buckle Up - Q&A's (English) | 05/01/2016 |
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UIB-1221B | How To Apply for UI Benefits (Bilingual) | 04/01/2016 |
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UIB-1219B | How to File Your Weekly Claim (Bilingual) | 04/01/2016 |
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DDD-1627B | FACT SHEET - Blood Lead Poisoning | 06/01/2015 |
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DDD-1627C | FACT SHEET - Immunizations (Shots) (English/Spanish) | 06/01/2015 |
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DDD-1627A | FACT SHEET - Advance Directives End of Life Care (Eng/Spa) | 06/01/2015 |
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DDD-1717A | Hot Topics - Heat Hazards | 05/01/2015 |
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DDD-1698A-S | Dental Care Ages Birth - 21 (Spanish) | 04/01/2015 |
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DDD-1698A | Dental Care Ages Birth - 21 (English) | 04/01/2015 |
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DDD-1700A | Keep Your Baby Healthy | 02/01/2015 |
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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