You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
EAP-1000A | Need Help Paying Your Energy Bill | 10/01/2022 |
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ESA-1060A | Need Help Finding a Job? | 10/01/2022 |
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SNA-1075A | Need Help Finding A Job | 04/01/2023 |
|
WIO-1153A | Need Help Finding A Job | 11/01/2021 |
|
EAP-1000A-S | Necesita ayuda para pagar su factura de energia | 10/01/2022 |
|
DDD-1260A-S | Navigating the System (Spanish) | 03/01/2024 |
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DDD-1260A | Navigating the System (English) | 03/01/2024 |
|
UB-108 | Name and Address Change Request (English / Spanish) | 03/01/2018 |
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DDD-2232A | Naloxone to Treat Opioid Overdose/Naloxona para Tratar la Sobredosis de Opioides (English/Spanish) | 08/01/2023 |
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FAA-1839A | MyFamilyBenefits Postcard (English/Spanish) | 06/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DD-524-FFS | Autorización para Entregar Información | 10/01/2018 |
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APS-1032A-S | Autorización para Divulgar Información sin cobertura de HIPAA | 08/01/2023 |
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RSA-1213A-SLP | Autorización para Divulgación de Información de Salud a RSA (Letra Grande) | 09/01/2022 |
|
RSA-1312A-S | Autorización Para Divulgación De Información De Salud a RSA | 07/01/2019 |
|
RSA-1313A-SLP | Autorización de Divulgación de Registros de RSA (Letra Grande) | 09/01/2022 |
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RSA-1313A-S | Autorización de Divulgación de Registros de RSA | 05/01/2018 |
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FAA-1765A-S | Autoridad para Divulgar Información | 05/01/2023 |
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FAA-0059A-S | Autoridad para Divulgar Expedientes | 06/01/2023 |
|
ESA-1220A-S | Autoevaluación Para Determinar La Preparación Laboral | 09/01/2018 |
|
FAA-1493A-SLP | Authorized Representative Request - Large Print (Spanish) | 04/01/2024 |
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