You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
|
FAA-0255A | Separate Household Status Statement | 05/01/2023 |
|
FAA-1494A-S | Remoción de un(a) Representante Autorizado(a) | 05/01/2023 |
|
FAA-1004A-XLP | Designation of EBT Alternate Card Holder - Extra Large Print (English) | 05/01/2023 |
|
FAA-0257A | Individual Development Account Agreement | 05/01/2023 |
|
FAA-0412A-SXLP | Change Report - Extra Large Print (Spanish) | 05/01/2023 |
|
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
|
FAA-0053A-LP | Verification of New/Current Employment - Large Print (English) | 05/01/2023 |
|
FAA-0053A | Verification of New/Current Employment (English) | 05/01/2023 |
|
FAA-0559A | Food Distribution / Nutrition Assistance Program Participation | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2093A | DDD Behavioral Health Advocate Referral | 03/01/2021 |
|
DDD-2092A | DDD Behavioral Health Advocacy Plan | 03/01/2021 |
|
DDD-2092A-S | Plan de Defensa de la Salud Conductual de la DDD | 03/01/2021 |
|
UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
|
UB-010-S | Eligibility Review Questionnaire (Spanish) | 02/01/2021 |
|
DDD-2087A | Documentation Guidelines: Occupational, Physical, and Speech-Language Pathology Therapy Services | 02/01/2021 |
|
FAA-1796A | Affidavit of Visually Viewed Documentation | 02/01/2021 |
|
RSA-1396A | Secure Email Waiver | 02/01/2021 |
|
RSA-1298A | Referral Form (English) | 02/01/2021 |
|
RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
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