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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AAA-1122A | Host Agency Application | 08/01/2019 |
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UIB-1241A | Take Care of Unemployment Business by the Internet or Telephone (English) | 08/01/2019 |
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UIB-1241A-S | Take Care of Unemployment Business by the Internet or Telephone (Spanish) | 08/01/2019 |
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DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
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RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
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DDD-0524A | Authorization for Release of Information (English) | 08/01/2019 |
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UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
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DDD-1721A | Building a Relationship with a Direct Care Worker (English) | 08/01/2019 |
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DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
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UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 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-1658A-S | Agency With Choice: Individual Representative (Spanish) | 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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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