You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-1249A | Verification of Disability | 05/01/2023 |
|
CCA-0221A | Family Child Care Provider Statement of Services | 05/01/2023 |
|
AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
|
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
|
FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
|
FAA-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
|
FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
|
CCA-0221A-S | Declaración de Servicios del Proveedor de Cuidado en Casa de Familia | 05/01/2023 |
|
AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
|
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-1530A-SLP | Managed Risk Agreement Services and/or Placement -Large Print (Spanish) | 03/01/2021 |
|
DDD-2090A | Program Integrity Requirements Verification | 03/01/2021 |
|
DDD-2093A | DDD Behavioral Health Advocate Referral | 03/01/2021 |
|
DDD-2092A | DDD Behavioral Health Advocacy Plan | 03/01/2021 |
|
DDD-2092A-S | Plan de Defensa de la Salud Conductual de la DDD | 03/01/2021 |
|
ESA-1338A | Language Line Translation Services Utilized | 03/01/2021 |
|
RSA-1298A | Referral Form (English) | 02/01/2021 |
|
FAA-1796A | Affidavit of Visually Viewed Documentation | 02/01/2021 |
|
RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
|
RSA-1396A | Secure Email Waiver | 02/01/2021 |
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