Regular Request - Arkansas Department of Human Services 2025

Get Form
Regular Request - Arkansas Department of Human Services Preview on Page 1

Here's how it works

01. Edit your form 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 it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out Regular Request - Arkansas Department of Human Services with our platform

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2
  1. Click ‘Get Form’ to open the Regular Request - Arkansas Department of Human Services in the editor.
  2. Begin by filling in the 'Agency Administering the Program' section with the relevant agency name.
  3. Next, enter the 'Site Name' and 'License #' in their respective fields to ensure proper identification.
  4. Complete the 'Program Director' section along with their email and telephone number for direct communication.
  5. Provide both the physical and mailing addresses of your center site facility, ensuring accuracy for correspondence.
  6. Indicate your years of operation, hours of operation (open and close), number of staff, and number of children served.
  7. Detail the ages of children/youth served and specify the type of technical assistance needed or areas of concern.
  8. Finally, include a justification for your needs and provide your name/title as well as a contact telephone number.

Start using our platform today to fill out your form online for free!

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.
Contact us
EBT benefits were taken out of hundreds of Arkansas benefit accounts without the account holders knowing, leaving families across the state forced to make tough decisions without those EBT/SNAP benefits available to them.
DHS must make public records available upon request unless the records are in active use or storage, in which case, DHS must do so within 3 working days. Disclosures are subject to various exemptions under federal and state law. You can request records by clicking here.
Oversee the states public mental health system, helping thousands of people access critical care each year. Serve, protect, empower, educate, and encourage children, at-risk youth, families, adults, aging adults and seniors, and people with disabilities so they move toward a better future, and so much more.