You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
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FAA-1765A | Authority to Release Information | 05/01/2023 |
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CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
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FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
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FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
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DDD-1622A | Home Modification Requests Support Coordinator’s (SC) Checklist (English) | 05/01/2023 |
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FAA-0255A | Separate Household Status Statement | 05/01/2023 |
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FAA-0051A | Verification of Financial Accounts (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-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1984A | Behavior Plan / Packet Requirements (English) | 11/01/2021 |
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CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
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CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
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DDD-1984A-S | Behavior Plan / Packet Requirements (Spanish) | 11/01/2021 |
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CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
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SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
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DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
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DDD-2101A | Electronic Visit Verification (EVV) Paper Timesheet Attestation (English) | 09/01/2021 |
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CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/Spanish) | 09/01/2021 |
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DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
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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