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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FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
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FAA-0051A | Verification of Financial Accounts (English) | 05/01/2023 |
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FAA-0053A-LP | Verification of New/Current Employment - Large Print (English) | 05/01/2023 |
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FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
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FAA-0559A | Food Distribution / Nutrition Assistance Program Participation | 05/01/2023 |
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GCI-1041A-S | Consentimiento para el Uso del Seguro de Salud | 05/01/2023 |
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DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
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CCA-1170AS | Petición para el Retiro o Terminación de Solicitud - Para Proveedores de Cuidado de Niños | 05/01/2023 |
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FAA-0412A-LP | Change Report - Large Print (English) | 05/01/2023 |
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FAA-1725A-S | Verificación de Otros Ingresos | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
ESA-1338A | Language Line Translation Services Utilized | 03/01/2021 |
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AAA-1218A | Arizona Family Caregiver Support Program (FCSP) Quarterly Summary Report | 03/01/2021 |
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DDD-1530A-SLP | Managed Risk Agreement Services and/or Placement -Large Print (Spanish) | 03/01/2021 |
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DDD-2090A | Program Integrity Requirements Verification | 03/01/2021 |
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DDD-2093A | DDD Behavioral Health Advocate Referral | 03/01/2021 |
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DDD-2092A | DDD Behavioral Health Advocacy Plan | 03/01/2021 |
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UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
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UB-010-S | Eligibility Review Questionnaire (Spanish) | 02/01/2021 |
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RSA-1298A | Referral Form (English) | 02/01/2021 |
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LCR-1087A | Child Developmental Certified Home Application Cover Page | 02/01/2021 |
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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