You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1533A | Verification of Unfitness for Work for Adults | 05/01/2023 |
FAA-0255A | Separate Household Status Statement | 05/01/2023 |
FAA-1494A-S | Remoción de un(a) Representante Autorizado(a) | 05/01/2023 |
FAA-1565A-S | Acuerdo de Prueba de Drogas para recibir Asistencia Nutricional | 05/01/2023 |
FAA-1799A | Drug/Alcohol Treatment Center Training Acknowledgment | 05/01/2023 |
FAA-1353A | Affidavit Attesting Citizenship for Cash Assistance and Nutrition Assistance | 05/01/2023 |
FAA-1701A | Verification of Terminated Employment (English) | 05/01/2023 |
CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
FAA-1494A-XLP | Authorized Representative Removal (Extra Large Print) | 05/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
GCI-1082A | Consent for Screening - Prior Written Notice | 06/01/2020 |
SNA-1000A | Rights and Responsibilities (English) | 06/01/2020 |
GCI-1082A-S | Consentimiento para Evaluación - Notificación Previa por Escrito | 06/01/2020 |
LCR-1053A | Renewal Application Worksheet (English) | 06/01/2020 |
GCI-1088A | Child and Family Assessment Guide for Families (Accessible) | 06/01/2020 |
SNA-1000A-S | Rights and Responsibilities (Spanish) | 06/01/2020 |
GCI-1020AS | Authorization to Disclose Protected Health Information (Spanish) | 06/01/2020 |
GCI-1039AS | Autorización para Obtener Información | 05/01/2020 |
AAA-1355A | APS Registry Employer Certification Form | 05/01/2020 |
GCI-1020A | Authorization to Disclose Protected Health Information | 05/01/2020 |
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