UPDATE: PUA claimants who were not able to certify for eligible weeks prior to April 19 are now able to file for eligible weeks back to their last date of employment (but no earlier than February 2). Individuals must file weekly PUA certifications for each week for which they are claiming eligibility for benefits, including retroactive certifications back to their last date of employment. Individuals who have already received the initial phase of payment will not see the option to certify for the three weeks for which they have already been paid. File weekly certifications at https://pua.azdes.gov.
UPDATE: Pandemic Emergency Unemployment Compensation (PEUC), which provides an extension of unemployment benefits, will be available in Arizona June 6.
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| Download | Number | Form Name | Effective Date |
|---|---|---|---|
|
AAA-1211A | Request for Durational Limit Waiver | 01/01/2011 |
|
DES-1036AS | Informe de Información de Salud Confidencial Divulgada (PHI por sus siglas en inglés) | 01/01/2011 |
|
AAA-1121A | Host Agency Monitoring and Safety Check | 01/01/2011 |
|
AAA-1123A | Agreement for Community Service Assignment | 01/01/2011 |
|
DES-1040A | Request for Alternative Means of Communication Protected Health Information | 01/01/2011 |
|
DES-1038A | Request for Amended/Correction of Protected Health Information | 01/01/2011 |
|
DES-1035A | Request for an Accounting of Disclosures of Protected Health Information | 01/01/2011 |
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DES-1034A | Accounting Disclosure Tracking | 01/01/2011 |
|
DES-1039A | Request for Restriction of Protected Health Information | 01/01/2011 |
|
DES-1036A | Accounting of Disclosures of Protected Health Information | 01/01/2011 |
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