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Arizona Department of Child Safety

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Arizona Department of Child Safety
Phone: Child Abuse Hotline 1-888-767-2445
Arizona Department of Child Safety<br> Logo
Arizona Department of Child Safety
CLICK to Report Child Abuse or Neglect
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  • Home
  • About
    • About DCS
    • Engage
    • Field Offices
    • Policy & Procedure
      • DCS Policy & Procedure
      • DCS Rules & Rulemaking
      • DCS Equal Employment Opportunity Policy
      • DCS Non-Discrimination Policy
      • DCS Limited English Proficiency Policy
    • Procurement & Contracts
    • Strategic Plan
    • Community Advisory Committee
    • Volunteer
      • Community Screening Partners
      • Get Involved
      • Community / Volunteer Interest Form
      • FACT Program
      • Giving Tree
    • Contact Us
  • Careers
    • Career Opportunities
      • Child Safety Specialist
      • Child Welfare Investigative Specialist (OCWI)
      • Search All Positions
    • We Are Compassioneers
  • News & Reports
    • News Releases
    • DCS Reports
    • Performance Measures
      • DCS Monthly / Semi-Annual Report
      • Agency Progress
    • Child Fatalities / Near Fatalities
    • Process for Release of Info
    • Settlement - Tinsley v. Faust
  • Parents
    • Parent Guide
    • Parents Rights
    • Parent Advisory Collaborative
  • Foster & Adoption
    • Foster Care
      • Start the Journey! Orientation
      • Learn More
      • Therapeutic Foster Care
      • Licensing Agencies
      • Information Events
      • Kinship Resources
      • Go-to Guide
      • Foster & Kinship FAQ's
    • Adoption
      • Adoption Stories
    • Shared Parenting
    • Children's Heart Gallery
    • Search AdoptUSKids
    • Newsletter
  • Resource
    • Frequently Asked Questions
    • Request DCS Information
    • Complaint or Disagreement
      • Ombudsman Complaint Form
    • DCS Forms
    • DCS Brochures & Flyers
  • Services
    • Mercy Care DCS Comprehensive Health Plan
      • For Members
      • For Providers
      • Health and Wellness
      • News and Updates
      • Contact Us
      • Language and Translation
    • DCS Service Array
    • Prevention
      • Safe Sleep
      • Arizona Families F.I.R.S.T.
      • Healthy Families Arizona
      • Regional Child Abuse Prevention Councils
      • Resources for Parents
      • Back-To-School Resources and Tips for Parents
    • Investigations and OCWI
    • Office of Licensing & Regulation (OLR)
    • Young Adult
      • Young Adult Program
      • Young Adult Resources
      • Youth Empowerment Council
      • Transitional Independent (TILP)
      • National Youth in Transition Database
    • Victims' Rights
  • Report Child Abuse
    • Child Abuse Hotline
    • Mandated Reporter Overview Training
    • Safe Haven Newborn
    • SB1114 - Child Abuse Hotline Required Posting
  • Home
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  • DCS Forms

DCS Forms

Find a document:    

  1. Enter a keyword or a form number in the Find a Document field and click the Search button.

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  3. Click on the Effective Date column header to sort the search results by date.    

 

Download Number Form Name Effective Date
PDF icon Download (135.05 KB) Dental Matri Dental Matrix (CMDP) 01/01/2013
PDF icon Download (61.56 KB) CRS App Span Application for Enrollment into AHCCCS CRS (Spanish) 09/01/2013
Microsoft Office document icon Download (39.5 KB) CSO-1006A Dentist's Certification of Medical Necessity 07/01/2014
File Download (16.69 KB) DCS-1040A-S HIPAA Privacy Complaints (Spanish) 08/01/2014
Microsoft Office document icon Download (62 KB) DCS-1049A-S Accounting of Disclosures of Protected Health Information (PHI) (Spanish) 08/01/2014
Microsoft Office document icon Download (40.5 KB) DCS-1041A HIPAA Privacy Complaint Confirmation of Receipt 08/01/2014
Microsoft Office document icon Download (60.5 KB) DCS-1050A Accounting Disclosure Tracking 08/01/2014
Microsoft Office document icon Download (43.5 KB) DCS-1041A-S HIPAA Privacy Complaint Confirmation of Receipt (Spanish) 08/01/2014
Microsoft Office document icon Download (67 KB) DCS-1050A-S Accounting Disclosure Tracking (Spanish) 08/01/2014
Microsoft Office document icon Download (40.5 KB) DCS-1042A Response to HIPAA Privacy Complaint 08/01/2014
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