You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-0257A | Individual Development Account Agreement (English) | 05/01/2023 |
FAA-1249A-XLP | Verification of Disability (Extra Large Print) | 05/01/2023 |
CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
FAA-1799A | Drug/Alcohol Treatment Center Training Acknowledgment | 05/01/2023 |
FAA-0098C-S | Solicitud de Audiencia por Ajuste de Transacción EBT | 05/01/2023 |
AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
FAA-0259A | Unwed Minor Parent Abuse/Neglect Claim | 05/01/2023 |
FAA-1494A-LP | Authorized Representative Removal - Large Print (English) | 05/01/2023 |
CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
DDD-0524A-S | Authorization for Release of Information (Spanish) | 08/01/2019 |
RSA-1376A | Request for Vending Services Placement | 08/01/2019 |
CCA-1260A-S | Solicitud de Proveedor Suplente | 07/01/2019 |
CCA-1261A-S | Solicitud de Proveedor Certificado de Cuidado de Niños Familiar | 07/01/2019 |
UB-099-Y | Certification of Understanding (English / Spanish) | 07/01/2019 |
LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (English) | 07/01/2019 |
CCA-1260A | Back Up Provider Application | 07/01/2019 |
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