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-1987A-S | Agreement of Behavior Plan (Spanish) | 08/01/2024 |
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DDD-1991A | DDD Eligibility Checklist (English) | 10/01/2022 |
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DDD-1991A-S | DDD Eligibility Checklist (Spanish) | 10/01/2022 |
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DDD-2010A | Out-of-Network Claims Submission Guide | 05/01/2019 |
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DDD-2013A | Residential Service Options | 12/01/2021 |
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DDD-2013A-S | Opciones de servicios residenciales | 12/01/2021 |
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DDD-2025A | DDD Tribal Health Program Fee-for-Service Claims Submission Guide (English) | 10/01/2021 |
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DDD-2036A | Member Funds Monthly Ledger (English) | 12/01/2020 |
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DDD-2039A-LP | HCBS Member Needs Assessment (Large Print) | 05/01/2022 |
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DDD-2039A-S | HCBS Member Needs Assessment (Spanish) | 05/01/2022 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
LCR-1051A | Permission for Transfer of Record | 04/01/2023 |
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LCR-1051A-S | Permiso Para Transferir el Archivo | 04/01/2023 |
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LCR-1052A | On-Going Professional Development Plan | 04/01/2023 |
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LCR-1053A | Renewal Application Worksheet (English) | 06/01/2020 |
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LCR-1053A-S | Renewal Application Worksheet (Spanish) | 04/01/2015 |
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LCR-1054A | Initial Application Worksheet | 10/01/2022 |
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LCR-1054A-S | Formulario de Solicitud Inicial | 01/01/2021 |
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LCR-1056A | Applicant Statement of Understanding for Child or Adult Developmental Home | 04/01/2023 |
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LCR-1056A-S | Declaración de Entendemiento del Solicitante par Hogar de Desarrollo para Niño o Adulto | 04/01/2023 |
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LCR-1063A | Developmental Home License Denial, Revocation or Suspension Hearing Request | 10/01/2020 |
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