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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CCA-1140A-S | Direct Deposit Enrollment - Centers and Group Homes (Spanish) | 09/01/2022 |
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DDD-1734A | Individually Designed Living Arrangement (IDLA) Assurances (English) | 09/01/2022 |
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UIB-1091A | Information Regarding Direct Deposit/Agreement for Direct Deposit (English) | 09/01/2022 |
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ETA-83 | Weekly Request for Assistance | 09/01/2022 |
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DDD-1734A-S | Individually Designed Living Arrangement (IDLA) Assurances (Spanish) | 09/01/2022 |
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LCR-1025A | Application for Initial HCBS Certification (English) | 09/01/2022 |
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UIB-1091A-S | Information Regarding Direct Deposit/Agreement for Direct Deposit (Spanish) | 09/01/2022 |
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ETA-083-S | Solicitud Semanal de Asistencia | 09/01/2022 |
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ETA-081 | Initial Application for Disaster Unemployment Assistance | 09/01/2022 |
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ETA-081-S | Solicitud Inicial de asistencia para desempleados por desastre | 09/01/2022 |
Download | Number | Name | Effective Date |
---|---|---|---|
|
CSA-1070A | Domestic Violence Housing Intervention Performance Measures | 02/01/2018 |
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CSE-1284A | Parent’s agreement to be bound by genetic test results (Eng/Spa) | 02/01/2018 |
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DDD-1590A | Monthly Invoice Cover Sheet (English) | 02/01/2018 |
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WIO-1061A | Training Provider Monitoring Tool | 01/01/2018 |
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LCR-1040A | Health Self-Disclosure | 01/01/2018 |
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WIO-1061B | Training Program Monitoring Tool | 01/01/2018 |
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LCR-1040A-S | Divulgación de Información de Salud Personal/Declaración del Médico | 01/01/2018 |
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PPP-1127A-S | Authorization for Disclosure of Protected Health Information (Spanish) | 01/01/2018 |
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PPP-1127A | Authorization for Disclosure of Protected Health Information | 01/01/2018 |
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DDD-1692A | Prevention and Support Instructor Recertification Packet (English) | 01/01/2018 |
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