You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
|
FAA-0412A-LP | Change Report - Large Print (English) | 05/01/2023 |
|
FAA-0065A-SXLP | Verification of Living Arrangements/Residential Address - Extra Large Print (Spanish) | 05/01/2023 |
|
FAA-1725A | Verification of Other Income | 05/01/2023 |
|
GCI-1033A-S | Resumen de la Conferencia de Transición | 05/01/2023 |
|
FAA-0412A | Change Report (English) | 05/01/2023 |
|
CCA-0221A | Family Child Care Provider Statement of Services | 05/01/2023 |
|
FAA-1249A | Verification of Disability | 05/01/2023 |
|
DDD-1678A | Home Modifications Service Assessment (English) | 05/01/2023 |
|
FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-1235A-S | CCA Informe de Cambios | 11/01/2021 |
|
SNA-1066A | Voluntary Participation Agreement | 10/01/2021 |
|
DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
|
LCR-1079A | Developmental Home Compliance Review | 09/01/2021 |
|
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan | 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-2101A | Electronic Visit Verification (EVV) Paper Timesheet Attestation (English) | 09/01/2021 |
|
DDD-2100A | DDD Electronic Visit Verification Paper Timesheet | 09/01/2021 |
|
CSE-1129A | Electronic Payment Authorization (English) | 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