Texas Health and Human Services Forms

This form is used for requesting pre-authorization for a breast MRI in Texas.

This Form is used for participating in the Youth Prevention Universal Program in Texas. It is a letter written in Spanish.

This Form is used for requesting pre-authorization for office-based procedures performed in an ambulatory surgical center in Texas.

This Form is used for completing a Family Service Plan in Texas.

This Form is used for requesting reimbursement for complications related to breast and cervical diagnostic procedures in Texas.

This form is used for requesting job postings for the Women, Infants, and Children (WIC) program in Texas.

This Form is used for WIC Director Orientation Training in the state of Texas.

This form is used for WIC vendors in Texas to request materials.

This form is used for authorizing the photographing or recording of residents of State Supported Living Centers (SSLCs) or patients of State Hospitals (SHs) in Texas.

This document is used to obtain authorization to photograph or record a resident of a state residential center or a patient of a state hospital in Texas.

This form is used for providing feedback and general information regarding the Women, Infants, and Children (WIC) program in Texas.

This form is used for verifying the curriculum of a nursing program by an accredited school in Texas.

This Form is used for the Ten-Day Long-Term Care Experience Life Safety Code Facility Observation Program in Texas. It serves as a checklist to ensure compliance with safety codes in long-term care facilities.

This form is used for documenting the checklist of the ten-day long-term care experience facility observation program in Texas.

This form is used for reviewing academic and alternative education requirements in Texas.

This form is used for applying for an internship by a non-school preceptor in Texas.

This document is used to record the completion of an internship by a non-school preceptor in Texas.

This form is used for filing complaints related to the National Firearms Act (NFA) in the state of Texas.

This Form is used for applying for inactive status in Texas.

This form is used for updating or requesting duplicate firearms license information in Texas.

This Form is used for requesting a Criminal History Evaluation Letter in Texas.

This form is used for nursing facility administrators in Texas who wish to apply for certification as a preceptor. It is used to provide necessary information and qualifications for the certification process.