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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DDD-1988A | PRC Disposition (English) | 03/01/2022 |
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DDD-1988A-S | PRC Disposition (Spanish) | 03/01/2022 |
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DDD-1991A | DDD Eligibility Checklist (English) | 10/01/2022 |
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DDD-1991A-S | DDD Eligibility Checklist (Spanish) | 10/01/2022 |
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DDD-2010A | Out-of-Network Claims Submission Guide | 05/01/2019 |
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DDD-2013A | Residential Service Options | 12/01/2021 |
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DDD-2013A-S | Opciones de servicios residenciales | 12/01/2021 |
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DDD-2025A | DDD Tribal Health Program Fee-for-Service Claims Submission Guide | 10/01/2021 |
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DDD-2036A | Member Funds Monthly Ledger (English) | 12/01/2020 |
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DDD-2045A | DDD Member Councils | 12/04/2019 |
Download | Number | Name | Effective Date |
---|---|---|---|
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LCR-1034A-S | Criminal History Self Disclosure Affidavit (Spanish) | 10/01/2019 |
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LCR-1040A | Health Self-Disclosure | 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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LCR-1041A | Voluntary Withdrawal of Application for Licensure or Voluntary Closure of License | 07/01/2023 |
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LCR-1041A-S | Retiro Voluntario de la Solicitud de Licenciamiento o Cierre Voluntario de Licencia | 07/01/2023 |
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LCR-1051A | Permission for Transfer of Record | 04/01/2023 |
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LCR-1051A-S | Permiso Para Transferir el Archivo | 04/01/2023 |
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LCR-1052A | On-Going Professional Development Plan | 04/01/2023 |
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LCR-1053A | Renewal Application Worksheet (English) | 06/01/2020 |
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LCR-1053A-S | Renewal Application Worksheet (Spanish) | 04/01/2015 |
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