Forms: Arizona

Simplifying Arizona’s Self-Directed Services Process.

On this page, you’ll find forms Participants and Direct Care Professionals (Workers) in the Veterans Independence Plus program of Southern Arizona program will need to manage their relationship and comply with requirements and regulations.

Important Timesheet Notice from PremierFMS

Effective October 13, 2024, you and/or your Direct Care Professionals will need to submit all timesheets or related documentation by email to PayrollTimesheets@premier-fms.com or send via fax to 855.325.4668.

Documents that need be submitted to this inbox or fax number include:

Timesheets
Mileage logs
Vendor claims
Reimbursement requests

The email inbox and fax number are NOT to be used for general inquiries. They are set up only to be used to submit documentation for payments, per the payroll schedule for your program.

All other document submissions may continue be sent to PremierFMS as you normally would. These changes only apply to the document types listed above.

For additional copies of timesheets, please go to the Programs page on our website and click on Forms under your home state.

These changes will assist our payroll department in processing your submissions more efficiently and lead to quicker payments to Direct Care Professionals.

Direct Care Professional (Worker)

Direct Care Professional Packet

2025 Payroll Schedule

e-Timesheets User Manual

Form Resources

Sample I-9 Completed Form

Sample SS-4 Completed Form

Sample 8821 Completed Form

Sample 2678 Completed Form

IRS Signature Requirements

Terms to keep in mind

There are a number of different words used in self-direction to refer to the individuals who contract for and receive services, as well as the individuals who provide those services. Here’s a quick guide to these words and who they refer to on our site and in other resources:

Participant: This refers to the individual contracting for and receiving services. Other common terms include Employer, Member, Client, or Consumer.

Direct Care Professional: This refers to the individual providing services. Other common terms include Caregiver, Care Provider, Provider, Employee, or Direct Staff.