You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
FAA-1249A | Verification of Disability | 05/01/2023 |
FAA-1208A-XLP | Language Notification Flyer (Extra Large Print) | 03/01/2021 |
FAA-1208A-LP | Language Notification Flyer (Large Print) | 02/01/2021 |
FAA-1208A | Language Notification Flyer | 01/01/2021 |
FAA-1182A | AHCCCS Fraud Prevention Determination Authorization | 07/01/2023 |
FAA-1148A | Medical Incapacity Statement (Hospitalized Applicant) | 07/01/2023 |
FAA-1111A-XLP | Participant Statement Verification Worksheet (Extra Large Print) | 06/01/2023 |
FAA-1111A-SXLP | Formulario para Verificar la Declaración del Participante (Letra extra grande) | 06/01/2023 |
FAA-1111A-SLP | Formulario para Verificar la Declaración del Participante (Letra grande) | 06/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FAA-1004A-LP | Designation of EBT Alternate Card Holder - Large Print (English) | 04/01/2023 |
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
FAA-0837A | Authorization to Open an IDA | 06/01/2023 |
FAA-0620A | Treatment Center Change Report | 05/01/2023 |
FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
FAA-0574A-SXLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Extra Grande) | 05/01/2023 |
FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
FAA-0574A-S | Retirar o Suspender Beneficios/Solicitud de Apelación | 05/01/2023 |
FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
FAA-0574A | Withdrawal or Stop Benefits/Appeal Request | 05/01/2023 |
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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