Arkansas Department of Human Services Forms

This type of document provides information about the Arkansas licensure site for professional licenses.

This form is used for applying for a license as a community support systems provider in the state of Arkansas.

This type of document is used to track self-employment income for individuals in the state of Arkansas.

This Form is used for essential service workers in Arkansas seeking assistance for early childhood and out of school time programs.

This form is used for reporting the dental disposition of a medical assistance case in Arkansas.

This form is used for applying for licensure for adult developmental day treatment in Arkansas.

This document is the application form for obtaining a license for Early Intervention Day Treatment in the state of Arkansas.

This document is an application for the Certification Program of All-inclusive Care for the Elderly in the state of Arkansas.

This Form is used for changing the address of a healthcare provider in Arkansas.

This Form is used to request a case file in Arkansas. Obtain important documents relating to a legal case.

This document is used to request an investigation file in the state of Arkansas.

This form is used for renewing a Nursing Home Administrator License in Arkansas.

This document is for submitting additional course offerings for approval in Arkansas for continuing education.

This Form is used for requesting adjustments to Medicaid XIX in the state of Arkansas.

This Form is used for applying to become a Family Support Partner, Peer Support Specialist, or Youth Support Specialist in Arkansas.

This document is for individuals in Arkansas who want to apply for an Infant Toddler Certificate. It is used to certify that individuals have completed the necessary training to work with infants and toddlers.

This document is used for applying for membership with the Arkansas Lifespan Respite Coalition. It is for individuals or organizations interested in becoming members of the coalition and supporting respite care services in Arkansas.

This document provides a checklist for essential service workers in Arkansas to ensure they have completed all necessary steps for their application.

This document grants official approval to an entity to conduct business in the state of Arkansas. It is required for certain business activities such as opening a bank account, obtaining permits, and entering into contracts.

This form is used for reporting computer incidents in Arkansas educational institutions.

This document is used for reviewing student performance in educational institutions in Arkansas.

This document is for applying to the Lifespan Respite Voucher Program in Arkansas. It provides an application form needed to access respite services for caregivers of individuals with disabilities or special needs.

This Form is used for requesting a Practitioner Identification Number in Arkansas.

This form is used for contacting volunteers for the SMP (Senior Medicare Patrol) program in the state of Arkansas.

This form is used for PCP (Primary Care Provider) participation agreement in the state of Arkansas. It outlines the agreement between a PCP and the Arkansas Department of Human Services.

Esta solicitud es para el Programa de Vales para Cuidado de Relevo Lifespan en Arkansas. Este programa proporciona ayuda financiera a las familias que cuidan de un ser querido con discapacidad para que puedan tomar descansos y recibir cuidado de relevo. Para más información o para solicitar el programa, complete esta solicitud.

This document is for applying to the Lifespan Respite Voucher Program in Arkansas, specifically for individuals who speak Marshallese. This program provides vouchers to caregivers who need respite services for their loved ones.

This form is used for providing information about substance abuse treatment sites in Arkansas.

This type of document is a request for a military waiver regarding nursing assistant certification education in the state of Arkansas.

This type of document is for military spouses who want to apply for an expedited nurse aide training program in Arkansas.