You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0065A | Verification of Living Arrangements/Residential Address (English) | 05/01/2023 |
|
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
|
FAA-0412A-XLP | Change Report - Extra Large Print (English) | 05/01/2023 |
|
FAA-0255A | Separate Household Status Statement | 05/01/2023 |
|
FAA-1546A | Sponsor Deeming Information | 05/01/2023 |
|
DDD-1622A | Home Modification Requests Support Coordinator’s (SC) Checklist (English) | 05/01/2023 |
|
FAA-1565A | Nutrition Assistance Drug Testing Agreement | 05/01/2023 |
|
GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
|
FAA-0412A-LP | Change Report - Large Print (English) | 05/01/2023 |
|
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
|
CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
|
CCA-0024A | Employment and Wage Verification Statement (English) | 11/01/2021 |
|
DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
|
SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
|
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
|
DDD-2099A-S | Plan de contingencia/respaldo del miembro para la verificación de visita electrónica (EVV) | 09/01/2021 |
|
DDD-2100A-S | Hoja de horas de verificación de visita electrónica de DDD | 09/01/2021 |
|
CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
|
DDD-2100A | DDD Electronic Visit Verification Paper Timesheet | 09/01/2021 |
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