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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UIA-1060A | Filing of Weekly Claims (English/Spanish) | 08/01/2019 |
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DDD-1721A-S | Building a Relationship with a Direct Care Worker (Spanish) | 08/01/2019 |
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DDD-1721A | Building a Relationship with a Direct Care Worker (English) | 08/01/2019 |
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UIB-0098A | Eligibility Investigation Record | 08/01/2019 |
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DDD-0524A | Authorization for Release of Information (English) | 08/01/2019 |
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DDD-1328A | Referral to Vocational Rehabilitation (English) | 08/01/2019 |
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POU-003 | Notice to Employees (English) | 08/01/2019 |
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POU-003-S | Notice to Employees (Spanish) | 08/01/2019 |
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UIB-1241A | Take Care of Unemployment Business by the Internet or Telephone (English) | 08/01/2019 |
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UIB-1241A-S | Take Care of Unemployment Business by the Internet or Telephone (Spanish) | 08/01/2019 |
Download | Number | Name | Effective Date |
---|---|---|---|
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DDD-1580A | Reversal Adjustment Request Cover Sheet (English) | 02/01/2023 |
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FAA-0001U | Notice of Non-Discrimination/Aviso De No Discriminación AH-1000 | 02/01/2023 |
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LCR-1084A | Application for Renewal or Amended HCBS Certificate for Independent Providers | 02/01/2023 |
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DDD-1658A | Agency With Choice: Individual Representative (English) | 02/01/2023 |
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DDD-2173A | Request for Amended/Correction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-1658A-S | Agency With Choice: Individual Representative (Spanish) | 02/01/2023 |
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LCR-1084A-S | Solicitud de Renovación o Certificado de HCBS Modificado para Proveedores Independientes | 02/01/2023 |
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DDD-2171A | Accounting Disclosures Tracking | 02/01/2023 |
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DDD-2174A | Request for Restriction of Protected Health Information (PHI) | 02/01/2023 |
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DDD-2172A | Authorization of Disclosure of Confidential Substance Use Disorder (SUD) Record Information | 02/01/2023 |
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