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Documents Center
Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Find a Document
- Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down.
- Type in a number or keyword in the "Search by Name, Number, or Keyword" box and click the Search button. When searching for a document by the exact title (form name), place the title within quotation marks.
- You can click on the column headers to sort the search results.
| Number | Document Name | Effective Date |
|---|---|---|
| FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
| AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
| FAA-1506A | Statement of No Income (English) | 05/01/2023 |
| FAA-1506A-S | Statement of No Income (Spanish) | 05/01/2023 |
| FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
| DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
| FAA-1353A-S | Afidávit que Certifica la Ciudadanía para recibir Asistencia en Efectivo y Asistencia Nutricional | 05/01/2023 |
| CCA-1170A | Withdrawal or Termination Request for Child Care Providers | 05/01/2023 |
| FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
| AzEIP-TAB-05012023 | Updated Consent to Bill Health Insurance form (GCI-1041A) Guidance Technical Assistance Bulletin | 05/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| SNA-1000A | Rights and Responsibilities (English) | 06/01/2020 |
| SNA-1000A-S | Rights and Responsibilities (Spanish) | 06/01/2020 |
| GCI-1088A | Child and Family Assessment Guide for Families (Accessible) | 06/01/2020 |
| CSE-1016A | Waiver of Paternity Affidavit (English/Spanish) | 06/01/2020 |
| GCI-1088A-S | Guía de Evaluación para los Niños y sus Familias | 06/01/2020 |
| GCI-1084A | Hearing Screening Tracking (English) | 06/01/2020 |
| GCI-1084A-S | Hearing Screening Tracking (Spanish) | 06/01/2020 |
| AAA-1355A | APS Registry Employer Certification Form | 05/01/2020 |
| GCI-1020A | Authorization to Disclose Protected Health Information | 05/01/2020 |
| GCI-1039A | Consent to Obtain Information | 05/01/2020 |
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Arizona State Resources
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
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