Family and Social Services Administration

State of Indiana

Official Website: https://forms.in.gov

The Indiana Archives and Records Administration (IARA) assists State and local governments in the cost-effective, efficient and secure management of governmental records, by providing services throughout the life cycle of records, including creation, use, storage, and disposition.

Forms & Documents

Browse all Family and Social Services Administration government forms

21 - 40 of 300 forms

Form Title Topics
Application for Replacement of Indiana Interpreter Certificate or Identification Card Family And Social Services Administration
Application for the Residential Care Assistance Program Family And Social Services Administration
Application for Undue Hardship Waiver Family And Social Services Administration
Application for Voluntary Treatment at State Hospital Family And Social Services Administration
Application / Worksheet for Caregiver Support Services Family And Social Services Administration
Attachment for the Aged & Disabled Waiver, the Medically Fragile Children Waiver, the TBI Waiver, and the AL and AFC Waiver Family And Social Services Administration
Authorization for Disclosure of Personal and Health Information Family And Social Services Administration
Authorization for Disclosure of Personal and Health Information - DFR Family And Social Services Administration
Authorization for Disclosure of Personal and Health Information - OMPP Family And Social Services Administration
Authorization for Release of Case Status Information Family And Social Services Administration
Authorization to Release and Share Medical Information Family And Social Services Administration
Authorized Representative for Health Coverage Family And Social Services Administration
Authorized Representative for SNAP (Food Assistance) and Cash Assistance Family And Social Services Administration
Behavioral / Physical Health Coordination Family And Social Services Administration
Block Grant Plan of Action Family And Social Services Administration
BQIS Guidelines Pre-Transition Quality Assurance Checklist Family And Social Services Administration
BQIS Post-Transition Quality Assurance Checklist Family And Social Services Administration
BQIS Pre-Transition QA Checklist Family And Social Services Administration
Certification by Physician for Long-Term Care Services and Physical Examination for PASARR Level II Family And Social Services Administration
Certification of Disability for Non-Vocational Rehabilitation Program Family And Social Services Administration

Contact Information & Office Locations

1 contact point

IARA Central Office (Records and Forms Management)

Address:
IARA Central Office (Records and Forms Management):
402 W. Washington Street
Room W472
Indianapolis, IN 46204-2744

Phone numbers:
  • (317) 232-3380 (IARA Central Office (Records and Forms Management))
  • (317) 591-5222 (Indiana State Archives)
  • (317) 233-3746 (State Imaging and Microfilm Lab)
  • (317) 591-5326 (Records Center)
Fax numbers:
  • (317) 233-1713 (IARA Central Office (Records and Forms Management))
  • (317) 591-5324 (Indiana State Archives)
  • (317) 591-5328 (Records Center)

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