Texas Health and Human Services Forms

1554
total templates

Documents

1554

Form H1003 "Appointment of an Authorized Representative to Allow Another Person to Act for You" - Texas

Rate (5 / 5) 1 votes
Size: 99 KB
1 page

This form may be used in the state of Texas when individuals would like to let another person legally act for them in certain situations.

Form 5506-NAR "Texas Nurse Aide Registry Employment Verification" - Texas

Rate (4 / 5) 22 votes
Size: 84 KB
2 pages

This form is used and needs to be completed by a nurse aide and their employer to verify employment. To remain on active status and to provide services in nursing facilities, nurse aides have to do such verifications at least every two years.

Form HRG-83 "Ssn Maintenance Memorandum" - Texas

Rate (4.7 / 5) 14 votes
Size: 192 KB
2 pages

Instructions for Form 325 "Primary Health Care Annual Reporting Form" - Texas

Rate (4.5 / 5) 10 votes
Size: 296 KB
5 pages

Form 1048 "Summary Sheet for Services to Individuals With Idd in Nf" - Texas

Rate (4.5 / 5) 71 votes
Size: 115 KB
1 page

Form 2605 "Member Sk-Sai Mdcp Review Signature" - Texas

Rate (4.7 / 5) 10 votes
Size: 114 KB
2 pages

Form H1175 "Ebt Change Request" - Texas

Rate (4.4 / 5) 21 votes
Size: 186 KB
1 page

Form 3209 "Chemical Dependency Treatment Facility Licensure Application Checklist for Change in Status Applicants" - Texas

Rate (4.3 / 5) 32 votes
Size: 115 KB
2 pages

Form 3900 "Application for Certificate of Deafness for Tuition Waiver" - Texas

Rate (4.4 / 5) 10 votes
Size: 116 KB
2 pages

Form 3031 "Children With Special Health Care Needs (Cshcn) Program Application" - Texas

Rate (4.5 / 5) 24 votes
Size: 160 KB
12 pages

Form 8584 "Comprehensive Nursing Assessment" - Texas

Rate (4.6 / 5) 36 votes
Size: 248 KB
19 pages

Form 2962 "Verification of Liability Insurance" - Texas

Rate (4.7 / 5) 35 votes
Size: 105 KB
1 page

Form H1822 "Abawd E&t Work Requirement Verification" - Texas

Rate (4.8 / 5) 13 votes
Size: 104 KB
1 page

Form H1172 "Ebt Card, Pin and Data Entry Request" - Texas

Rate (4.8 / 5) 57 votes
Size: 214 KB
1 page

Form 3610 "Informal Review Request" - Texas

Rate (4.4 / 5) 47 votes
Size: 205 KB
1 page

Form 1347 "Emflaza Authorization Request (Medicaid)" - Texas

Rate (4.6 / 5) 25 votes
Size: 117 KB
2 pages

Form 5534 "Medication Aide General Statement Enrollment" - Texas

Rate (4.6 / 5) 23 votes
Size: 117 KB
2 pages

Form 5523 "Medication Aide Experience Documentation Report" - Texas

Rate (4.5 / 5) 8 votes
Size: 113 KB
1 page

Form 8648 "Identification of Preferences" - Texas

Rate (4.5 / 5) 70 votes
Size: 106 KB
1 page

Form 4205 "Consent by Foster Parent or Medical Consenter for Health Passport" - Texas

Rate (4.4 / 5) 8 votes
Size: 115 KB
3 pages

Form 1325 "Synagis Prior Authorization Addendum (Cshcn)" - Texas

Rate (4.5 / 5) 26 votes
Size: 128 KB
4 pages

Form 1321 "Synagis Standard Prior Authorization Addendum (Medicaid)" - Texas

Rate (4.4 / 5) 48 votes
Size: 129 KB
4 pages

Form 8660 "Performance Evaluation of Internship/Practicum Supervisor and Overall Experience" - Texas

Rate (4.5 / 5) 17 votes
Size: 112 KB
1 page

Form 3008 "Cost Share Collections/Refund Report" - Texas

Rate (4.4 / 5) 38 votes
Size: 90 KB
1 page

Form 3015 "Application for a Child Care Administrator License or a Child-Placing Agency Administrator License" - Texas

Rate (4.5 / 5) 36 votes
Size: 121 KB
3 pages

Form 1319 "Pharmacy Claims Billing Request" - Texas

Rate (4.4 / 5) 43 votes
Size: 114 KB
1 page

Form 1054 "Community Living Options" - Texas

Rate (4.5 / 5) 27 votes
Size: 130 KB
6 pages

Form 3955 "Application for Driver Identification Visor Card" - Texas

Rate (4.7 / 5) 12 votes
Size: 115 KB
1 page

Form 4211 "Respite Funding Agreement" - Texas

Rate (4.3 / 5) 33 votes
Size: 113 KB
1 page

Form 3016 "Administrator Licensing - Reference for an Applicant" - Texas

Rate (4.7 / 5) 22 votes
Size: 114 KB
2 pages

Form 0011 "Consent to Transfer to a Texas State Operated Facility" - Texas

Rate (4.3 / 5) 20 votes
Size: 109 KB
1 page

Form 0012 "Request for Interstate Transfer" - Texas

Rate (4.4 / 5) 20 votes
Size: 116 KB
1 page

Form 3222 "Confidentiality of Patient Records" - Texas

Rate (4.7 / 5) 19 votes
Size: 109 KB
1 page

Form 2071 "Monthly Report of Nutrition Services Incentive Program (Nsip) Eligible Meals and Title Xx Meals" - Texas

Rate (4.6 / 5) 16 votes
Size: 112 KB
1 page

Form 6004 "Texas Provider Marketing" - Texas

Rate (4.4 / 5) 9 votes
Size: 110 KB
1 page

Form 8636 "Volunteer/Intern Assignment Description" - Texas

Rate (4.8 / 5) 14 votes
Size: 86 KB
1 page

Form 6517 "Individual Program Plan (Ipp) Service Review" - Texas

Rate (4.5 / 5) 27 votes
Size: 167 KB
16 pages

Form 3091 "Comprehensive Nursing Assessment" - Texas

Rate (4.5 / 5) 16 votes
Size: 249 KB
18 pages

Form 3001 "Quarterly Financial Report" - Texas

Rate (4.7 / 5) 28 votes
Size: 124 KB
2 pages