You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
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LCR-1084A-S | Solicitud de Renovación o Certificado de HCBS Modificado para Proveedores Independientes | 02/01/2023 |
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CCA-1216A | Notice to All Families Enrolled at DES Child Care Facility/Aviso A Todas Las Familias Inscritas En Una Instalación De Cuidado De Niños Del DES | 02/01/2023 |
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LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers | 02/01/2023 |
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DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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CSE-1225A | Caretakers Raising Children | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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CSE-1225A-S | Cuidadores que Crían Niños | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CCA-0218A | Sign-In/Sign-Out Record (English) | 10/01/2019 |
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CCA-0218B | Sign-In/Sign-Out Record (Extended Version) | 10/01/2019 |
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CCA-0218B-S | Registro de Entradas y Salidas (Versión extendida) | 10/01/2019 |
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LCR-1034A-S | Criminal History Self Disclosure Affidavit (Spanish) | 10/01/2019 |
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DDD-1532A | Hardship Reduction Request (English) | 09/01/2019 |
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DDD-1532A-S | Hardship Reduction Request (Spanish) | 09/01/2019 |
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RSA-1383A | BEP Training - Applicant Checklist | 09/01/2019 |
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RSA-1386A | BEP 8 Step Process | 09/01/2019 |
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CCA-1116A | Child Care Assistance Priority Waiting List Income Table | 09/01/2019 |
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RSA-1384A | BEP Job-Shadowing Evaluation | 09/01/2019 |
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