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Documents Center
Reports, Forms, Pamphlets and Policies
You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Find a Document
- Click on the tab that corresponds with the type of document type you are looking for, or click on the "All Documents" tab to search through all available documents. You can refine your search by selecting a category from the Filter by Category drop-down.
- Type in a number or keyword in the "Search by Name, Number, or Keyword" box and click the Search button. When searching for a document by the exact title (form name), place the title within quotation marks.
- You can click on the column headers to sort the search results.
| Number | Document Name | Effective Date |
|---|---|---|
| CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (English) | 05/01/2023 |
| FAA-1546A-S | Sponsor Deeming Information (Spanish) | 05/01/2023 |
| CCA-1163A-S | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger (Spanish) | 05/01/2023 |
| FAA-0098C-S | Solicitud de Audiencia por Ajuste de Transacción EBT | 05/01/2023 |
| FAA-1366A | Eligibility Requirements | 05/01/2023 |
| FAA-0620A | Treatment Center Change Report | 05/01/2023 |
| DDD-0211A | Home Modifications Service Referral and Request (English) | 05/01/2023 |
| CCA-1164A | Affidavit of Immunization Exemption - For Children in Care (English) | 05/01/2023 |
| FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request - Large Print (English) | 05/01/2023 |
| FAA-0098C | EBT Transaction Adjustment Hearing Request | 05/01/2023 |
| Number | Document Name | Effective Date |
|---|---|---|
| CCA-1260A | Back Up Provider Application | 07/01/2019 |
| CCA-1261A | Certified Family Child Care Provider Application | 07/01/2019 |
| UB-099-Y | Certification of Understanding (English / Spanish) | 07/01/2019 |
| LCR-1007A | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (English) | 07/01/2019 |
| LCR-1007A-S | Home Visit Report Supplement to Notice of Inspection and Due Process Rights (Spanish) | 07/01/2019 |
| GCI-1049A | No Contact Letter | 07/01/2019 |
| CCA-0206A-S | Cuestionario para la Entrevista de Certificación Inicial | 07/01/2019 |
| RSA-1367A-SLP | Derechos de Apelación (Letra Grande) | 06/01/2019 |
| CCA-1259A | DES Certified Home-Based Child-Care Provider Pre Application (English) | 06/01/2019 |
| RSA-1367A | Appeal Rights | 06/01/2019 |
Arizona State Resources
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
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