You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download |
Number |
Name | Effective Date |
---|---|---|---|
|
DDD-2069A | DDD Eligibility Packet (English) | 11/01/2022 |
|
DDD-2069A-S | DDD Eligibility Packet (Spanish) | 11/01/2022 |
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DDD-2073A | Long Term Care / Home and Community Based Services Claims Submission Guide | 09/01/2020 |
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DDD-2076A | DDD Health Plan Care Management Referral (English) | 11/01/2023 |
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DDD-2082A | Report Suspected Abuse, Neglect or Exploitation | 09/01/2020 |
|
DDD-2082A-S | Reportando Sospechas de Abuso, Negligencia, o Explotación | 09/01/2020 |
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DDD-2084A | Everyone has the right to be safe (Adult) | 04/01/2021 |
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DDD-2084A-S | Todos tienen derecho a estar seguros (Adulto) | 04/01/2021 |
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DDD-2084B | Everyone has the right to be safe (Child) | 04/01/2021 |
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DDD-2084B-S | Todos tienen derecho a estar seguros (Niño) | 04/01/2021 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
LCR-1040A | Health Self-Disclosure | 01/01/2018 |
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LCR-1040A-S | Divulgación de Información de Salud Personal/Declaración del Médico | 01/01/2018 |
|
LCR-1041A | Voluntary Withdrawal of Application for Licensure or Voluntary Closure of License | 07/01/2023 |
|
LCR-1041A-S | Retiro Voluntario de la Solicitud de Licenciamiento o Cierre Voluntario de Licencia | 07/01/2023 |
|
LCR-1051A | Permission for Transfer of Record | 04/01/2023 |
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LCR-1051A-S | Permiso Para Transferir el Archivo | 04/01/2023 |
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LCR-1052A | On-Going Professional Development Plan | 04/01/2023 |
|
LCR-1053A | Renewal Application Worksheet (English) | 06/01/2020 |
|
LCR-1053A-S | Renewal Application Worksheet (Spanish) | 04/01/2015 |
|
LCR-1054A | Initial Application Worksheet | 10/01/2022 |
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