Department of Economic Security Forms and Office Locations – Government Agency in Arizona

The Arizona Department of Economic Security makes Arizona

stronger by helping Arizonans reach their potential through temporary

assistance for those in need, and care for the vulnerable.

121 - 140 of 922 forms

Form Title	Topics
Authority to Release Information
Authority to Release Information
Authority to Release Information
Authority to Release Student Information
Authorizacion Para Divulgacion de la Informacion Protegida de Salud
Authorization for Disclosure of Protected Health Information
Authorization for Release of Information
Authorization to Disclose Protected Health Information
Authorization to Disclose Protected Health Information (Spanish)
Authorization to Open an IDA
Authorization to Open an IDA
Authorization to Open an IDA
Authorization to Share Information (English/Spanish)
Authorized Representative Removal
Authorized Representative Removal
Authorized Representative Removal
Authorized Representative Removal
Authorized Representative Removal (Extra Large Print)
Authorized Representative Removal (Extra Large Print)
Authorized Representative Removal (Extra Large Print)

1 contact point

Address:
3406 N 51st Ave
Phoenix, AZ 85031

Phone numbers:

Department of Economic Security