Inter Tribal Council of Arizona

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  • Member Tribes
    • Ak-Chin Indian Community
    • Cocopah Indian Tribe
    • Colorado River Indian Tribes
    • Fort McDowell Yavapai Nation
    • Fort Mojave Indian Tribe
    • Gila River Indian Community
    • Havasupai Tribe
    • Hopi Tribe
    • Hualapai Tribe
    • Kaibab Band of Paiute Indians
    • Pascua Yaqui Tribe
    • Pueblo of Zuni
    • Quechan Tribe
    • Salt River Pima-Maricopa Indian Community
    • San Carlos Apache Tribe
    • San Juan Southern Paiute
    • Tohono O’odham Nation
    • Tonto Apache Tribe
    • White Mountain Apache Tribe
    • Yavapai-Apache Nation
    • Yavapai-Prescott Indian Tribe
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Title III Reporting Forms

View Links, Handbooks, and Resources Here 

2023-ITCA-Title-III-Reports per Service (1)

A Matter of Balance

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Caregiver Training

  • Caregiver Reg Forms (Caregiver Training)
  • Caregiver Assessment Tool (CAT) Fillable Form

Caregiver Outreach / Caregiver Information & Referral

  • Caregiver Non Reg Forms

Congregate Meals

  • Short Form Intake Document (SFID)

Enhance Fitness

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Home Delivered Meals 

  • Short Form Intake Document (SFID)
  • 2024 Federal Poverty Guidelines _ ASPE
  • SFID Service Matrix DES AZ DAAS
  • SFID Overview Tribal Power Point

Long Term Care / Ombudsman

  • Monthly Ombudsman Data Collection Form
  • Case Complaint Form
  • 2024 Federal Poverty Guidelines _ ASPE

Public Benefit Outreach Project Form

  • Client Contact fillable form
  • Group Outreach and Education Form_PAM
  • Media Outreach and Education form
  • FPL and Income Eligibility Chart

Respite Care Forms

  • Caregiver Reg and Non Reg forms
  • Respite Care Form 2022
  • FY2022 Social_Svcs_Report_-Non-Reg

Socialization & Recreation

  • SocRec-Monthly-Reporting-Form FY2025
  • SocRec-Monthly-Reporting-Form
  • SocRec-Monthly-Reporting-Form_Rev
  • SocRec-Sign-in-Sheet2
  • SocRec-Summary-Report_

Supplemental Handouts

  • ITCA-Title-III-Reporting-summary-Tribes
  • Clients Rights & Responsibility
  • Grievance Procedure & Cost Sharing
  • DAARS Instructions Rev 4.25
  • Authorization for Release of Confidential Information

Transportation

  • Social Services Report_Non-Reg
  • Monthly Report Form – Transportation
  • Vehicle Inspection Checklist 

Current News

  • Environmental Quality Programs Spring 2026 Internship

  • Notice of RFP Cancellations

  • Corona Virus 2019 (COVID-19) Resources

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Current Events

  • Volunteer Income Tax Assistance (VITA) Tax Year 2025

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Employment Opportunities

Register to VOTE!


CLICK HERE to Register

ITCA Member Tribes

  • Ak-Chin Indian Community
  • Cocopah Indian Tribe
  • Colorado River Indian Tribes
  • Fort McDowell Yavapai Nation
  • Fort Mojave Indian Tribe
  • Gila River Indian Community
  • Havasupai Tribe
  • Hopi Tribe
  • Hualapai Tribe
  • Kaibab Band of Paiute Indians
  • Pascua Yaqui Tribe
  • Pueblo of Zuni
  • Quechan Tribe
  • Salt River Pima-Maricopa Indian Community
  • San Carlos Apache Tribe
  • San Juan Southern Paiute Tribe
  • Tohono O'Odham Nation
  • Tonto Apache Tribe
  • White Mountain Apache Tribe
  • Yavapai-Apache Nation
  • Yavapai-Prescott Indian Community

2214 North Central Avenue, Phoenix, AZ 85004 Phone: 602-258-4822 Fax: 602-258-4825, Copyright © 2011 - 2026 Inter Tribal Council of Arizona, Inc.

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