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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PPP-1136A | Health Insurance Portability and Accountability Act of 1996 - Business Associate Agreement (English) | 07/01/2023 |
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GCI-1134A | Child File Review Form: Indicator 7 45-Day Timeline (Guidance) | 07/01/2023 |
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FAA-1145A | Authorization to Share Information (English/Spanish) | 07/01/2023 |
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FAA-1714A-S | Mid Approval Contact - Lobby (Spanish) | 07/01/2023 |
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DDD-1783A | Habilitation Outcome Strategies (English) | 07/01/2023 |
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FAA-1818A-S | Deducción Estándar de Gastos Médicos de Asistencia Nutricional (NA) | 07/01/2023 |
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ESA-1306A | Employment Service Registration | 07/01/2023 |
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FAA-1410A-SXLP | Acuerdo de Solicitante y Guión de Desvío de Subvención (Letra Extra Grande) | 07/01/2023 |
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FAA-1819A-S | Seguridad y Prevención del Fraude de Tarjetas EBT | 07/01/2023 |
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FAA-1148A | Medical Incapacity Statement (Hospitalized Applicant) | 07/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
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WIO-1108A | WIOA EO Monitoring Review Guide | 02/01/2023 |
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
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DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 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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CCA-0100A-S | Información de las Operaciones de un Proveedor de Cuidado de Niños | 01/01/2023 |
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