You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-1546A | Sponsor Deeming Information | 05/01/2023 |
|
FAA-1494A-XLP | Authorized Representative Removal (Extra Large Print) | 05/01/2023 |
|
FAA-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
|
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
|
FAA-1546A-S | Información de Determinar a un Patrocinador | 05/01/2023 |
|
FAA-1565A | Nutrition Assistance Drug Testing Agreement | 05/01/2023 |
|
FAA-0412A-SXLP | Change Report - Extra Large Print (Spanish) | 05/01/2023 |
|
FAA-1768A | Overpayment Compromise Request Form | 05/01/2023 |
|
DDD-1678A | Home Modifications Service Assessment (English) | 05/01/2023 |
|
FAA-0065A-SLP | Verification of Living Arrangements/Residential Address - Large Print (Spanish) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
|
DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
|
CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
|
CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
|
CSE-1281A | Agreement to Accept Service by Mail Paternity or Establishment (English/Spanish) | 09/01/2021 |
|
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 09/01/2021 |
|
LCR-1079A | Developmental Home Compliance Review | 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 |
|
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