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-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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CCA-1216A | Notice to All Families Enrolled at DES Child Care Facility/Aviso A Todas Las Familias Inscritas En Una Instalación De Cuidado De Niños Del DES | 02/01/2023 |
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
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WIO-1108A | WIOA EO Monitoring Review Guide | 02/01/2023 |
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DDD-1883A-S | ¿Qué es PASRR? Una guía para las familias | 02/01/2023 |
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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-1883A | What is PASRR? | 02/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
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UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
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AAA-1122A | Host Agency Application | 08/01/2019 |
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DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
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RSA-1312A | Authorization for Disclosure of Health Information to RSA | 07/01/2019 |
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RSA-1312A-S | Autorización Para Divulgación De Información De Salud a RSA | 07/01/2019 |
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CCA-0206A-S | Cuestionario para la Entrevista de Certificación Inicial | 07/01/2019 |
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CCA-1260A-S | Solicitud de Proveedor Suplente | 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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