You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
RRP-1015A-Kibembe | Statement of Understanding (Kibembe) | 08/01/2023 |
DDD-2223A | RFQVA DDD-2024 Attestation of Policy Development Tool (English) | 08/01/2023 |
J-119 | Data Sharing Request/Agreement (Single Division) (English) | 08/01/2023 |
CSE-1163A | Employer Address Information | 08/01/2023 |
RRP-1015A-Kinyarwanda | Statement of Understanding (Kinyarwanda) | 08/01/2023 |
APS-1032A | Authorization to Release Non-HIPAA Information Form | 08/01/2023 |
UC-522-FF | Adjustment Report (English) | 08/01/2023 |
AAA-1301A | Adult Protective Services (APS) Records Request Form (English) | 08/01/2023 |
DDD-2051A_2023 | Policy Development Tool 2023 | 08/01/2023 |
RRP-1015A-Kirundi | Statement of Understanding (Kirundi) | 08/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
DDD-1972A-S | Application for Eligibility Determination Packet (Spanish) | 11/01/2022 |
CC-214-A | Relative Child Care Provider Rate Agreement | 11/01/2022 |
CC-214-A-S | Acuerdo de Tarifa para Parientes Proveedores de Cuidado de Niños | 11/01/2022 |
GCI-1147A | Records Request Response (AzEIP) | 10/01/2022 |
LCR-1005A | Notice of Inspection Rights (English) | 10/01/2022 |
CCA-0048A | Non-Certified Relative Provider Billing Report | 10/01/2022 |
LCR-1005A-S | Notice of Inspection Rights (Spanish) | 10/01/2022 |
CCA-0048A-S | Informe de Facturación de Proveedores Parientes no Certificados | 10/01/2022 |
DDD-1747A-S | Contrato De Residencia Para Las Residencias De Vivienda Asistida (ALF) | 10/01/2022 |
CCA-1021A | Unpaid Co-payment Worksheet | 10/01/2022 |
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