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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GCI-1083A | Consent for Child Assessment | 08/01/2020 |
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GCI-1038B | Consent for Evaluation - Prior Written Notice | 02/01/2020 |
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GCI-1082A | Consent for Screening - Prior Written Notice | 06/01/2020 |
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GCI-1041A | Consent to Bill Health Insurance | 05/01/2023 |
|
GCI-1039A | Consent to Obtain Information | 05/01/2020 |
|
GCI-1040A | Consent to Share Early Intervention Records and Information (English) | 02/01/2024 |
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GCI-1040A-S | Consent to Share Early Intervention Records and Information (Spanish) | 02/01/2024 |
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GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
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GCI-1038B-S | Consentimiento para Evaluación - Aviso Previo por Escrito | 02/01/2020 |
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GCI-1082A-S | Consentimiento para Evaluación - Notificación Previa por Escrito | 06/01/2020 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
UIB-1263A | Request for Overpayment Waiver (English) | 04/01/2023 |
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UIB-1263A-S | Request for Overpayment Waiver (Spanish) | 04/01/2023 |
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UIB-0126A | Request for Reconsideration/Appeal (English) | 06/01/2021 |
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UIB-0126A-S | Request for Reconsideration/Appeal (Spanish) | 06/01/2021 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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CSE-1158A | Request for Review of Arrears (English) | 10/01/2023 |
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CSE-1158A-S | Request for Review of Arrears (Spanish) | 10/01/2023 |
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CCA-1211A | Request for Search of Background Checks (English) | 05/01/2022 |
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CCA-1211A-S | Request for Search of Background Checks (Spanish) | 05/01/2022 |
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CSE-0167A | Request for Title IV-D Child Support Services and Applicant’s Rights and Responsibilities (English) | 01/01/2024 |
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