You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Number | Document Name | Effective Date |
---|---|---|
FAA-1513A-SLP | Consejos para Ahorrar Tiempo (Letra Grande) | 07/01/2023 |
LCR-1028A | Agency Roster of Employees (English) | 07/01/2023 |
FAA-1724A-LP | Application Signature Pages (Large Print) | 07/01/2023 |
CCA-0208A | Provider/Parent/Guardian's Agreement for Child Care Charges (English) | 07/01/2023 |
FAA-1513A-SXLP | Consejos para Ahorrar Tiempo (Letra Extra Grande) | 07/01/2023 |
FAA-0620D | Supplemental Pages for the Treatment Center Monthly Roster | 07/01/2023 |
FAA-1818A | Nutrition Assistance (NA) Medical Expense Deduction | 07/01/2023 |
FAA-1724A-XLP | Application Signature Pages (Extra Large Print) | 07/01/2023 |
CCA-0208A-S | Provider/Parent/Guardian's Agreement for Child Care Charges (Spanish) | 07/01/2023 |
FAA-1819A-S | Seguridad y Prevención del Fraude de Tarjetas EBT | 07/01/2023 |
Number | Document Name | Effective Date |
---|---|---|
CCA-0041A | Fair Hearing Request | 11/01/2021 |
CCA-0041A-S | Solicitud De Audiencia Imparcial | 11/01/2021 |
CCA-0044A | Verification of Shelter Case Plan (English) | 11/01/2021 |
CCA-0024A-S | Employment and Wage Verification Statement (Spanish) | 11/01/2021 |
DDD-1661A | DDD Tribal Health Program (THP) Equipment and Supplies Prior Authorization | 10/01/2021 |
SNA-1066A | Voluntary Participation Agreement (English) | 10/01/2021 |
CSE-1129A | Electronic Payment Authorization (English) | 09/01/2021 |
CSE-1129A-S | Electronic Payment Authorization (Spanish) | 09/01/2021 |
DDD-2099A | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan (English) | 09/01/2021 |
DDD-2099A-S | Electronic Visit Verification (EVV) Member Contingency/ Back-Up Plan (Spanish) | 09/01/2021 |
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