Texas Health and Human Services Forms

This form is used for creating a transition plan in the state of Texas. It outlines the steps and strategies for individuals transitioning between services or programs.

This form is used for reporting annual professional development activities in the Family Planning Program in Texas.

This form is used for creating a Habilitation Service Plan (HSP) in the state of Texas. The HSP is a document that outlines the services and support provided to individuals with disabilities to help them develop skills necessary for independent living.

This form is used for requesting an exemption from the Class D Pharmacy License requirement for pharmacies participating in the Texas Family Planning Program.

This form is used for reporting and tracking the distribution of Zika supplies in the state of Texas.

This form is used for creating an individual profile for nursing facility residents in Texas.

This form is used for applying for eligibility in the Breast and Cervical Cancer Services (BCCS) Program or Family Planning Program (FPP) in Texas.

This form is used for conducting a habilitative assessment in the state of Texas. It helps gather information to determine the needs and support required for individuals with disabilities to maximize their independence and quality of life.

This form is used for completing the Caregiver Status Questionnaire in Texas to determine eligibility for certain caregiver benefits.

This form is used for requesting a transfer of Pasrr Dme and Cmwc in the state of Texas.

This form is used for offering home and community-based services through the HCS program in Texas.

This form is used for withdrawing an offer made for the Home and Community-Based Services (HCS) Program in Texas.

This Form is used for certifying warrants that have been lost, destroyed, stolen, or not received in the state of Texas.

This form is used for daily inspections of buildings and grounds in Texas to ensure they are maintained and in good condition.

This form is used for residents in Texas to request to remain in a facility.

This Form is used for a physician to assess a patient's health condition in the state of Texas.

This Form is used for notifying the Fire Marshal/State Fire Marshal in Texas.

This document is used by fire suppression authorities in Texas to notify relevant parties about fire incidents and updates. It ensures effective communication and coordination in emergency situations.

This form is used for transmitting individually identifiable health information via fax in the state of Texas.

This form is used for reviewing Type C Assisted Living Facilities in Texas. It helps assess the quality and compliance of these facilities for the well-being of residents.

This Form is used for creating a Memorandum of Understanding between Texas Health and Human Services Commission (HHSC) and a Certified Community Behavioral Health Clinic (CCBHC) in Texas. It outlines the responsibilities and agreements between the two parties.

This form is used for the application process to become a Certified Community Behavioral Health Clinic (CCBHC) in the state of Texas.

This form is used for requesting information from the U.S. Department of Veteran Affairs in Texas. It requires the individual's authorization.

This Form is used for verifying civil services benefits in Texas.

This Form is used for requesting information from the Teacher Retirement System of Texas in the state of Texas.