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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FAA-1492A-S | Representantes Autorizados - Derechos y Responsabilidades | 07/01/2023 |
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FAA-1714A | Mid Approval Contact - Lobby (English) | 07/01/2023 |
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FAA-1148A | Medical Incapacity Statement (Hospitalized Applicant) | 07/01/2023 |
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ESA-1306A-S | Inscripción con el Servicio de Empleo | 07/01/2023 |
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FAA-1410A-SXLP | Acuerdo de Solicitante y Guión de Desvío de Subvención (Letra Extra Grande) | 07/01/2023 |
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FAA-1818A | Nutrition Assistance (NA) Medical Expense Deduction | 07/01/2023 |
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FAA-1714A-S | Mid Approval Contact - Lobby (Spanish) | 07/01/2023 |
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FAA-1182A | AHCCCS Fraud Prevention Determination Authorization | 07/01/2023 |
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FAA-1819A-S | Seguridad y Prevención del Fraude de Tarjetas EBT | 07/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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LCR-1025A | Application for Initial HCBS Certification (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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ETA-83 | Weekly Request for Assistance | 09/01/2022 |
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RSA-1213A-SLP | Autorización para Divulgación de Información de Salud a RSA (Letra Grande) | 09/01/2022 |
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ETA-083-S | Solicitud Semanal de Asistencia | 09/01/2022 |
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RSA-1365A-LP | Authorization/Consent for Disclosure and Use of Confidential Information Between DDD And RSA (Large Print) | 09/01/2022 |
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ETA-081 | Initial Application for Disaster Unemployment Assistance | 09/01/2022 |
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RSA-1365A-SLP | Autorización/Consentimiento para Divulgación y Uso de Información Confidencial entre DDD y RSA (Letra Grande) | 09/01/2022 |
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GCI-1096A | Individual Family Teaming Report | 09/01/2022 |
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ETA-081-S | Solicitud Inicial de asistencia para desempleados por desastre | 09/01/2022 |
Download | Number | Name | Effective Date |
---|---|---|---|
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UIT-1190A | UI Tax Online Reporting | 03/01/2019 |
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FAA-1700A | SAW Contact Card | 02/01/2019 |
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DDD-1945A | Support Coordination and You (English) | 01/01/2019 |
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DDD-1945A-S | Support Coordination and You (Spanish) | 01/01/2019 |
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HPY-330 | Article 52: Certification and Supervision of Family Child Care Home Providers (English/Spanish) – EFF | 12/01/2018 |
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DDD-1732A | Incontinence Briefs for Adults 21 Years and older (English) | 11/01/2018 |
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DDD-1732A-S | Incontinence Briefs for Adults 21 Years and older (Spanish) | 11/01/2018 |
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DUA-1002A | Disaster Unemployment Assistance (Bilingual) | 08/01/2018 |
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AAA-1167A-S | Asistencia Legal para los Arizonenses de la Tercera Edad | 08/01/2018 |
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AAA-1167A | Legal Assistance for Older Arizonans | 08/01/2018 |
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