Get the up-to-date DDD-1972A - Application for Eligibility Determination - Packet 2025 now

See details

4.9 out of 5

57 votes

The document is an application packet from the Arizona Department of Economic Security's Division of Developmental Disabilities (DDD) for individuals seeking eligibility for developmental disability services. It outlines the required information and documentation needed for the application, including proof of citizenship, guardianship documents, medical insurance details, and evidence of qualifying developmental disabilities. The packet also includes sections for applicant and guardian information, health insurance details, and authorizations for disclosure of protected health information.

Here's how it works

01. Edit your ddd application online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send ddd application online via email, link, or fax. You can also download it, export it or print it out.

The fastest way to redact DDD-1972A - Application for Eligibility Determination - Packet online

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Dochub is the best editor for updating your paperwork online. Follow this straightforward instruction to redact DDD-1972A - Application for Eligibility Determination - Packet in PDF format online at no cost:

Register and sign in. Register for a free account, set a strong password, and proceed with email verification to start working on your forms.
Upload a document. Click on New Document and choose the file importing option: upload DDD-1972A - Application for Eligibility Determination - Packet from your device, the cloud, or a secure URL.
Make changes to the sample. Take advantage of the upper and left-side panel tools to modify DDD-1972A - Application for Eligibility Determination - Packet. Insert and customize text, images, and fillable areas, whiteout unnecessary details, highlight the important ones, and comment on your updates.
Get your documentation accomplished. Send the sample to other people via email, generate a link for quicker file sharing, export the sample to the cloud, or save it on your device in the current version or with Audit Trail added.

Try all the advantages of our editor right now!

See more DDD-1972A - Application for Eligibility Determination - Packet versions

We've got more versions of the DDD-1972A - Application for Eligibility Determination - Packet form. Select the right DDD-1972A - Application for Eligibility Determination - Packet version from the list and start editing it straight away!

Versions	Form popularity	Fillable & printable
2020	4.3 Satisfied (54 Votes)
2019	4.9 Satisfied (57 Votes)

be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does claim for eligibility determination mean?

Claim for an Eligibility Determination means a Claim requesting a determination as to whether a claimant is eligible to be a Participant under a Plan. Based on 14 documents.

What is the difference between long term care and long term disability insurance?

Keep these two fundamental differences in mind: Individual and group long-term disability covers your income, while long-term care covers out-of-pocket expenses for long-term care.

What is determination for eligibility?

Determination of eligibility is an intervention undertaken upon completion of the assessment to establish if the assessed needs meet the national eligibility threshold. What? A determination of eligibility identifies which of the assessed needs are eligible and which ones are non-eligible.

Who is eligible for DDD in Arizona?

A person aged 6 years to adulthood must 1) voluntarily apply, 2) be an Arizona resident, and 3) be diagnosed with a developmental disability (listed below) which developed before the age of 18 and is likely to continue indefinitely, and 4) there must also be significant limitations in daily life skills related to the

What is the difference between DDD and ALTCS?

DDD provides support coordination for people who are DDD eligible, but do not qualify for the Arizona Long Term Care System (ALTCS). A support coordinator will assist the person in connecting with community resources.

ddd application arizona

DDD application online DDD Eligibility Packet DDD application status DDD application form DDD Provider Application DDD application Arizona DDD services for autism DDD/ALTCS application

Related forms

be ready to get more

Complete this form in 5 minutes or less

Get form

Who is eligible for ALTCS autism?

Generally, to qualify, an individual must be an Arizona resident, a U.S. citizen or qualified non-citizen, aged 65 or older, or have a disability or medical condition that requires ongoing care. Autism, being a developmental disability, falls under the category of a qualifying condition.

Is ALTCS the same as Ahcccs?

AHCCCS contracts with several program contractors to provide long term care services. An ALTCS program contractor works like a Health Maintenance Organization (HMO). The program contractor works with doctors, nursing homes, assisted living facilities, hospitals, pharmacies, specialists, etc. to provide care.

Get the up-to-date DDD-1972A - Application for Eligibility Determination - Packet 2025 now

Here's how it works

The fastest way to redact DDD-1972A - Application for Eligibility Determination - Packet online

See more DDD-1972A - Application for Eligibility Determination - Packet versions

Complete this form in 5 minutes or less

Got questions?

What does claim for eligibility determination mean?

What is the difference between long term care and long term disability insurance?

What is determination for eligibility?

Who is eligible for DDD in Arizona?

What is the difference between DDD and ALTCS?

Complete this form in 5 minutes or less

People also ask

Who is eligible for ALTCS autism?

Is ALTCS the same as Ahcccs?

ddd eligibility packet

Try more PDF tools