You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers (English) | 02/01/2023 |
DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
CCA-1216A | Notice to All Families Enrolled at DES Child Care Facility (English/Spanish) | 02/01/2023 |
DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
LCR-1084A-S | Application for Renewal or Amended HCBS Certificate for Independent Providers (Spanish) | 02/01/2023 |
DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
DDD-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 02/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
FA-065-FFS | Verificación de Arreglos de Vivienda/Dirección Residencial | 07/01/2017 |
DDD-1402B | Group Supported Employment - Six-Month Report (English) | 06/01/2017 |
DDD-1401B | Center Based Employment - Six Month Report | 06/01/2017 |
DDD-1402A | Group supported employment - Quarterly Report (English) | 06/01/2017 |
DDD-1404A | Employment Support Aide - Quarterly Report (English) | 06/01/2017 |
DDD-1404B | Employment Support Aide - Six Month Report (English) | 05/01/2017 |
FBU-1003A | DERS Direct Service Position (English) | 05/01/2017 |
UB-433-FF | Voluntary Election for Federal/State Income Tax Withholding (English/Spanish) | 05/01/2017 |
UB-101-A | Work Search Log (English / Spanish) | 04/01/2017 |
CCA-1114A | Contractor Eligibility Verification | 04/01/2017 |
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