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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DDD-1678A | Home Modifications Service Assessment (English) | 05/01/2023 |
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FAA-1249A-LP | Verification of Disability (Large Print) | 05/01/2023 |
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FAA-0053A | Verification of New/Current Employment (English) | 05/01/2023 |
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FAA-1768A | Overpayment Compromise Request Form | 05/01/2023 |
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FAA-0559A | Food Distribution / Nutrition Assistance Program Participation | 05/01/2023 |
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FAA-0065A-S | Verification of Living Arrangements/Residential Address (Spanish) | 05/01/2023 |
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CCA-1163A | Affidavit of Immunization Exemption - For Household Members Age 13 and Younger | 05/01/2023 |
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FAA-1765A | Authority to Release Information | 05/01/2023 |
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CSE-1061A | Establishing Paternity | 05/01/2023 |
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FAA-1768A-S | Formulario de Solicitud de Reducción de Pago en Exceso | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
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FAA-1796A | Affidavit of Visually Viewed Documentation | 02/01/2021 |
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RSA-1396A | Secure Email Waiver | 02/01/2021 |
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RSA-1298A | Referral Form (English) | 02/01/2021 |
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RSA-1298A-S | Referral Form (Spanish) | 02/01/2021 |
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RSA-1298A-LP | Referral Form - Large Print (English) | 02/01/2021 |
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LCR-1087A | Child Developmental Certified Home Application Cover Page | 02/01/2021 |
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RSA-1298A-S-LP | Referral Form - Large Print (Spanish) | 02/01/2021 |
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DDD-2087A | Documentation Guidelines: Occupational, Physical, and Speech-Language Pathology Therapy Services | 02/01/2021 |
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UB-010 | Eligibility Review Questionnaire (English) | 02/01/2021 |
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CSE-1315A | Federal Form - General Testimony | 01/01/2021 |
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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