NC Division of Aging and Adult Services-ARMS

Forms

Note: Some forms have been revised based on the new
ARMS Web Based System and others have been discontinued

DAAS-101 (Long Form-Print Version) DAAS-101 (Short Form-Print Version)	Client Registration Form The purpose of this form is to enter client data into the ARMS System in order to track units of service by client as well as to facilitate reporting, reimbursement, and data management at the state and local level. Form Instructions
ARMS User Request Form	Request for USER ACCESS to ARMS The purpose of this form is to submit information to request access, change or remove user's access to ARMS. This form should be e-mailed to Annette.Bagwell@dhhs.nc.gov. The provider code should lead with the region code. Example: L015 Form Instructions
DAAS-150	Provider Agency Form This form is completed annually and provides the information necessary to establish the agency as a community service provider on the ARMS. This form can be faxed to 919-733-0443, but e-mail is preferred. Form Instructions **The *Provider Agency data keyed in ARMS can be printed from ARMS under Reports, Other Report - ZGA-701 and/or ZGA-701-B*
DAAS-543	Consumer Contribution/Program Income All consumer contributions/program income collections for all unit and non-unit services should be submitted to the Area Agency on Aging or keyed in ARMS The *Consumer Contribution/Program Income* Data keyed in ARMS can be printed from ARMS under Reports, Verification Report - ZGA-543
DAAS-544	Non-Unit Reimbursement All reimbursement information contained on this form for non-unit services should be submitted to the Area Agency on Aging or keyed in ARMS *The Non-Unit Reimbursement Report Data keyed in ARMS can be printed from ARMS under Reports, Verification Report - ZGA-544*
DOA-300 No longer required	Provider Agency Validation Table - Site/Route/Worker The purpose of this form was to gather information concerning the site routes (points of service delivery) for all service providers. This information, when entered in the (ARMS), provides for the sorting of clients on the unit of service report and the unit of service verification report. *The Provider Agency Validation Table data keyed in ARMS can be printed from ARMS under Reports, Verification Report - ZGA-300*
DOA-301	No longer used
DOA-302 No longer required	Congregate Nutrition Site Information This form was used to gather name and address of congregate nutrition meal sites. *Congregate Nutrition Sites data keyed in ARMS can be printed from ARMS under Reports, Verification Report - ZGA-301*
DOA-402	No longer used

Last updated - November 9, 2010

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