Texas Health and Human Services Forms

This form is used for conducting a dental risk assessment for Texas Health Steps program. It is available in both English and Spanish.

This form is used for attesting that you are eligible to receive free testing kits in Texas.

This document is a checklist used in Texas to ensure building safety and environmental health measures are met. It covers various aspects such as fire safety, electrical systems, waste disposal, and more.

This document is used for making a sworn statement in Texas.

This document provides a detailed report on the fire safety survey conducted in hospitals and crisis stabilization units in Texas. It includes information on the evaluation of fire safety measures and recommendations for improvement.

This document is for renewing the license of a Crisis Stabilization Unit in the state of Texas.

This document provides instructions on what to do in the event of a hospital closure in Texas.

This document is used for certifying and authorizing individuals in Texas for a specific purpose. It may pertain to professional certifications or authorizations required by the state of Texas.

This document is a nutritional health worksheet specifically designed for residents of Texas. It provides information and guidance on maintaining a healthy diet and lifestyle.

This document is a career exploration plan specific to Texas. It helps individuals in Texas navigate their career options and develop a strategic plan for their future. It provides resources and guidance for researching different careers, setting goals, and creating an action plan to achieve them.

This form is used for assessing the satisfaction and feedback of consumers in Texas.

This document provides information about the Community First Choice program in Texas, which provides support for administrative assistance.

This type of document, known as DSHS Form B-13 State of Texas Purchase Voucher, is used for making and processing purchases by the Texas Department of State Health Services (DSHS). It provides the necessary information for tracking and recording financial transactions related to purchases made by the department.

This form is used for the caregiver assessment process in Texas, aimed at evaluating the needs and support required for caregivers providing care to individuals in need.

This document is for evaluating the needs of consumers in Texas. It helps identify and address the specific needs and concerns of consumers in the state.

This document provides a proposal for implementing clinical initiatives to improve the quality of Medicaid services in Texas.

This Form is used to claim travel expenses for clients who undergo home dialysis or kidney transplant in Texas.

This form is used for updating Medicare Part D coverage for kidney health care in Texas.

This form is used for kidney health care travel claim for home dialysis and kidney transplant patients in Texas.

This form is used for updating insurance information in the Kidney Health Care Program in Texas.

This Form is used for requesting the addition of UPC(s) to the WIC Authorized Product List (APL) in the state of Texas.

This Form is used for attesting to the security measures implemented for clinical management of behavioral health services in Texas.

This document provides a self-evaluation checklist specific to Texas. It helps individuals assess their performance and areas for improvement.

This form is used to collect client information for an appointment with a dietitian in Texas. It includes personal details, health history, and dietary preferences.

This form is used for referring individuals in Texas who are in need of high-risk counseling services.

This document tracks high-risk referrals and outcomes in the state of Texas. It provides data on referrals made for high-risk situations and the outcomes resulting from those referrals.

This document is used to track and record high-risk appointments in Texas. It helps in managing and monitoring appointments that have a higher potential for risk or safety concerns.

This document is for completing a Level 1 Screening as part of the PASRR (Pre-Admission Screening and Resident Review) process in Texas. It helps determine if an individual seeking admission to a nursing facility has any mental illness or intellectual disability.

This document provides instructions on how to complete the Pasrr Level 1 Screening, which is required in Texas.

This form is used for employment verification for the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Texas. It is available in both English and Spanish.

This form is used for healthcare providers in Texas to apply for enrollment in the HAP (Healthcare Access Program) network.

This document is a self-assessment tool in Texas to help individuals evaluate their overall wellness and aging process. It covers various aspects such as physical health, emotional well-being, social connections, and more to encourage individuals to age well and live a fulfilling life.

This document is a self-audit checklist for group class facilitation by the Ccne Group in Texas. It helps ensure that the facilitator is meeting the necessary standards for effective group class facilitation.

This document is a guide that is used for observing and evaluating nutrition education sessions in the state of Texas. It provides a set of criteria and guidelines to ensure effective delivery of nutrition education programs.

This document is a worksheet part of an evaluation toolkit for assessing issues specific to Texas. It provides a step-by-step guide for evaluating and assessing various issues in the state.

This document is a worksheet for Step 3 and Step 4 of the Evaluation Toolkit in Texas. It helps identify objectives and corresponding activities for evaluation purposes.

This Form is used for reporting primary health care activities at the end of the fiscal year in Texas.

This form is used for conducting a Level 1 screening for the Pasrr program in Texas. The Pasrr program ensures that individuals entering long-term care facilities are properly assessed for any mental health or intellectual developmental disability needs. The form provides instructions for completing the screening process.

This document is a form used in Texas for the Pasrr Comprehensive Service Plan (PCSP). It provides a comprehensive plan for services needed by individuals with mental health conditions.

This document is a Pasrr Evaluation specific to the state of Texas. It is used to assess the need for specialized services for individuals with mental illness or intellectual disabilities.