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-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
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DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 02/01/2023 |
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LCR-1084A-S | Solicitud de Renovación o Certificado de HCBS Modificado para Proveedores Independientes | 02/01/2023 |
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DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
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DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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CSE-1225A | Caretakers Raising Children | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers | 02/01/2023 |
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CSE-1225A-S | Cuidadores que Crían Niños | 02/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
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DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
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DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
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DDD-1328B | Referral to Vocational Rehabilitation Packet (English) | 08/01/2019 |
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LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights | 07/01/2019 |
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CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
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LCR-1007A-S | Informe de Visita al Hogar Suplemento Al Aviso de Derechos De Inspección y Debido Proceso | 07/01/2019 |
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GCI-1049A | No Contact Letter | 07/01/2019 |
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CCA-1259A | DES Certified Home-Based Child-Care Provider Pre Application | 07/01/2019 |
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CCA-1261A-S | Solicitud de Proveedor Certificado de Cuidado de Niños Familiar | 07/01/2019 |
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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