You can search for reports, forms, policies and pamphlet and posters with information about specific programs and services.
Download | Number | Name | Effective Date |
---|---|---|---|
|
FAA-0574A-LP | Withdrawal or Stop Benefits/Appeal Request (Large Print) | 05/01/2023 |
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GCI-1037A | Public Education Agency (PEA) Notification/Referral | 05/01/2023 |
|
FAA-1004A | Designation of EBT Alternate Card Holder (English) | 05/01/2023 |
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FAA-0574A-XLP | Withdrawal or Stop Benefits/Appeal Request (Large Extra Print) | 05/01/2023 |
|
DDD-1345A | Medical Justification for Home Modifications (English) | 05/01/2023 |
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CCA-1170AS | Petición para el Retiro o Terminación de Solicitud - Para Proveedores de Cuidado de Niños | 05/01/2023 |
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FAA-0620A | Treatment Center Change Report | 05/01/2023 |
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FAA-0574A-SLP | Retirar o Suspender Beneficios/Solicitud de Apelación (Letra Grande) | 05/01/2023 |
|
AAA-1296A | Protect Yourself and Medicare | 05/01/2023 |
|
FAA-0065A-LP | Verification of Living Arrangements/Residential Address - Large Print (English) | 05/01/2023 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
DDD-2102A-S | Electronic Visit Verification (EVV) Designee Attestation (Spanish) | 09/01/2021 |
|
DDD-2098A | Hourly Nursing Assessment Tool (H-NAT) | 09/01/2021 |
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AAA-1344A-S | Posición de Servicio Directo | 08/01/2021 |
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FAA-1810A | Register to vote (Bilingual) | 08/01/2021 |
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DERS-1057A | Direct Service Position | 08/01/2021 |
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LCR-1085A | Adult Protective Services Records Check Request | 08/01/2021 |
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AAA-1369A | Quarterly Report Packet | 08/01/2021 |
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AAA-1344A | Direct Service Position | 08/01/2021 |
|
CCA-1212A-S | Puesto de Servicio Directo (Formulario de certificación) | 07/01/2021 |
|
DDD-2104A | Member Interdisciplinary Team Summary | 07/01/2021 |
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