Texas Health and Human Services Forms

This document is used for a comprehensive evaluation of a person's hearing to determine the need for rehabilitation services in the state of Texas.

This form is used for reporting the results of a cardiac evaluation in the state of Texas.

This Form is used for requesting a waiver and agreement for modifying a residential site in Texas.

This form is used for notifying individuals about optional health care services in Texas.

This form is used for reporting medical information related to a disability caused by cancer in the state of Texas.

This form is used for reporting complaints and inquiries related to purchased services contracts on a monthly basis in Texas. It provides a way to track and address any issues or concerns raised by the public regarding these contracts.

This document is a quarterly program performance report for the state of Texas. It provides information and data on the performance of various programs in Texas.

This form is used for reporting program income on a quarterly basis in the state of Texas.

This form is used for reporting dental information in the state of Texas. It is used to provide details about dental treatments, diagnoses, and other relevant information.

This form is used for evaluating end-stage renal disease in Texas. It is a medical evaluation form for individuals with kidney failure.

This form is used for reporting final expenditures in Texas. It is used to provide a detailed breakdown of all expenses incurred during a specific period of time.

This form is used for the renewal of abortion facility licenses in the state of Texas.

This document is used for reporting quarterly financial information and analysis for a base/operational grant in the state of Texas.

This form is used for creating an inventory list of equipment in the state of Texas. It helps organizations keep track of the equipment they own.

This form is used for recording and sharing surgical and treatment recommendations in the state of Texas.

This Form is used for reporting personnel activity in the state of Texas.

This Form is used for reporting the closure of a chemical dependency treatment facility in Texas.

This type of document is used for renewing an ambulatory surgical center license in Texas.

This form is used for applying for an ambulatory surgical center license in the state of Texas.

This form is used for submitting emergency/disaster notifications in Texas. It helps in providing important information about emergencies or disasters to the relevant authorities.

This form is used for applying to set up an off-site facility in Texas to respond to the Covid-19 pandemic.

This Form is used for health care facilities in Texas to obtain certification under Executive Order Ga-15.

This form is used for keeping a daily record of the census in Texas. It helps track population changes and demographics on a daily basis.

This form is used for recording daily service delivery at residential care adult foster care facilities in Texas.

This Form is used for providing staff information to the provider in Texas.