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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PPP-1136A | Health Insurance Portability and Accountability Act of 1996 - Business Associate Agreement (English) | 07/01/2023 |
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CCA-1197A | Emergency Preparedness and Response Plan for Certified Family Child Care Providers | 07/01/2023 |
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FAA-1819A-S | Seguridad y Prevención del Fraude de Tarjetas EBT | 07/01/2023 |
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CCA-1190A | Tribal New Child Care Referral | 07/01/2023 |
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FAA-1818A | Nutrition Assistance (NA) Medical Expense Deduction | 07/01/2023 |
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FAA-1724A-SLP | Páginas de Firma de la Solicitud (Letra Grande) | 07/01/2023 |
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LCR-1028A | Agency Roster of Employees | 07/01/2023 |
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FAA-1818A-S | Deducción Estándar de Gastos Médicos de Asistencia Nutricional (NA) | 07/01/2023 |
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FAA-1724A-SXLP | Páginas de Firma de la Solicitud (Letra Extra Grande) | 07/01/2023 |
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FAA-0620C | Treatment Center Monthly Roster | 07/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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CCA-1021A-S | Informe de Copagos Atrasados | 10/01/2022 |
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GCI-1147A | Records Request Response (AzEIP) | 10/01/2022 |
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DDD-1747A-S | Contrato De Residencia Para Las Residencias De Vivienda Asistida (ALF) | 10/01/2022 |
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RSA-1313A-SLP | Autorización de Divulgación de Registros de RSA (Letra Grande) | 09/01/2022 |
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GCI-1096A | Individual Family Teaming Report | 09/01/2022 |
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RSA-1313A-LP | Authorization for Release of RSA Records (Large Print) | 09/01/2022 |
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LCR-1025A | Application for Initial HCBS Certification (English) | 09/01/2022 |
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UIB-1091A | Information Regarding Direct Deposit/Agreement for Direct Deposit (English) | 09/01/2022 |
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RSA-1312A-LP | Authorization for Disclosure of Health Information to RSA (Large Print) | 09/01/2022 |
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UIB-1091A-S | Information Regarding Direct Deposit/Agreement for Direct Deposit (Spanish) | 09/01/2022 |
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-1954-S | Participación en DDD | 07/01/2019 |
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CSE-1251A | Fact Sheet for Minor Parents (English/Spanish) | 07/01/2019 |
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DDD-0517A-S | Working With You (Spanish) | 06/01/2019 |
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GCI-1081A | Interagency Coordinating Council for Infants and Toddlers (Consejo de Coordinación Interinstitucional para Bebés y Niños Pequeños) | 06/01/2019 |
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DDD-0517A | Working With You (English) | 06/01/2019 |
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AAA-1324A | Senior Medicare Patrol (SMP) Fraud Alert - Genetic Testing | 05/01/2019 |
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DDD-2010A | Out-of-Network Claims Submission Guide | 05/01/2019 |
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CCA-1253A | Choosing Quality Child Care (English/Spanish) | 04/01/2019 |
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FAA-1375A | Nutrition Assistance Posters | 04/01/2019 |
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AAA-1316A | SNAP-O Partnership | 04/01/2019 |
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