Mother and Doctor Baby Arizona
 for mothers and mothers to be		 Arizona at Your Service

 

Provider Training Request

The provider will send office staff members to a training session held by the Department of Economic Security.

Staff training will be initiated when AHCCCS receives a signed Baby Arizona Participating Provider Agreement. Providers must send office staff members to the Baby Arizona training session before implementing the program in their offices.

The participating providers may request training for new staff members at any time by completing the form below or contacting the Maternal Child Health Coordinator at the following address: 701 E. Jefferson, MD 6700, Phoenix, AZ, 85034; or by fax at (602) 417-4162.

 

Provider name:  
Provider address  
Provider phone number:  
Provider email address:  
County:  
Contact person  name:  
How many staff need training:  
When would you like training:  
Do you have access to the internet in the provider office:  

 
This initiative was funded in part by the Governor's Office for Children, Youth, and Families/Governor's Division for Women.
AHCCCS, 801 E. Jefferson, Phoenix, AZ 85034, (602) 417-4000
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