Texas Health and Human Services Forms

This document is for creating an individual safety plan for residents in Texas. It helps individuals outline steps to ensure their safety in various situations.

This document is used for the random review of nursing on-call and/or deceased individuals in Texas. It requires the submission of necessary documentation.

This form is used for requesting preauthorization for conversion services in the state of Texas.

This document is used for reviewing findings and creating a plan of improvement in Texas.

This form is used for authorizing the disclosure of protected health information in Texas.

This form is used for adult individuals in Texas to assess their resilience and recovery. It is a standardized assessment tool used to evaluate an individual's mental health and gather important information for treatment and support.

This Form is used for reporting the Good Faith Effort made by contractors in Texas to meet the minority and women-owned business participation goals on government contracts.

This form is used for assessing the needs and strengths of children aged 3-5 in Texas. It helps to identify the support and interventions required for their well-being and development.

This Form is used for assessing the needs and strengths of children and adolescents aged 6-17 in Texas. It is called Form 3043 Mh Child and Adolescent Needs and Strengths (Cans).

This form is used for notifying individuals in Texas about their presumptive eligibility for primary and specialty health services.

This form is used for conducting an assessment and developing a personalized service plan for individuals receiving day activity and health services in Texas.

This form is used for assessing the eligibility and compliance of home and community-based services for adult mental health settings in Texas. It helps ensure that these services meet the required standards for providing care to individuals with mental health needs.

This form is used for notifying individuals about their rights and responsibilities in the Home Delivered Meals (HDM) program under the Social Security Act, Title XX in Texas. It also provides information on the complaint procedures and how to report allegations of abuse, neglect, or exploitation.

This form is used for recording the delivery of primary home care services in Texas. It helps keep track of the services provided to individuals in their own homes.