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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
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Arizona Department of Child Safety
CLICK to Report Child Abuse or Neglect
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  • Home
  • About
    • About DCS
    • Administration
      • Mike Faust, DCS Director
    • 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
    • Strategic Plan
    • Procurement & Contracts
    • Community Advisory Committee
    • Volunteer / Community
      • Get Involved
      • Community Partners
      • Community / Volunteer Interest Form
      • FACT Program
    • Contact DCS
  • Careers
    • Career Opportunities
      • DCS Specialist / DCS Trainee
      • DCS Child Welfare Investigative Specialist (OCWI)
    • Open Positions at DCS
    • 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
      • Steps for Becoming a Foster Parent
      • Is Foster Parenting Right for Me?
      • Foster Care Licensing Agency Matrix
      • Foster Care Information Session Events
    • Adoption
      • Adoption Stories
    • Children's Heart Gallery
    • Search AdoptUSKids
    • Foster & Kinship Caregiver Go-To-Guide
    • Foster & Kinship FAQ's
      • Foster Resources
      • Kinship Resources
    • AZ Thrive Newsletter
  • Resource
    • Frequently Asked Questions
    • Request DCS Information
    • Complaint or Disagreement
      • Ombudsman Complaint Form
    • DCS Forms
    • DCS Brochures & Flyers
    • Protective Services Review Team (PSRT)
  • Services
    • Comprehensive Medical & Dental Program (CMDP)
      • Members
      • Providers
      • Behavioral Health
      • Announcements
      • CMDP Provider Manual
      • Child Welfare Resources
      • Newsletters
      • Connecting Communities
      • Your Opinion Matters
      • LEP- Limited English Proficiency
    • Prevention
      • Safe Sleep
      • Arizona Families F.I.R.S.T.
      • Healthy Families Arizona
      • Regional Child Abuse Prevention Councils
      • In-Home Services Program
      • 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
      • Transitional Independent (TILP)
      • National Youth in Transition Database
    • Victims' Rights
  • Report Child Abuse
    • Child Abuse Hotline
    • Mandated Reporter Overview Training
    • Safe Haven Newborn
  • 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.

  2. Select a category from the Filter by Category drop-down and click the Search button.    

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

 

Download Number Form Name Effective Date
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
Microsoft Office document icon Download (50.5 KB) DCS-1051A Request for an Accounting of Disclosures of Protected Health 08/01/2014
Microsoft Office document icon Download (44 KB) DCS-1042A-S Response to HIPAA Privacy Complaint (Spanish) 08/01/2014
Microsoft Office document icon Download (52.5 KB) DCS-1051A-S Request for an Accounting of Disclosures of Protected Health (Spanish) 08/01/2014
Microsoft Office document icon Download (49 KB) DCS-1044A Authorization for Disclosure of Protected Health Information 08/01/2014
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