Texas Health and Human Services Forms

This Form is used for summarizing an individual's need for service in Texas. It helps to evaluate and determine the level of assistance required.

This form is used for notifying individuals about their status in the Medicaid Estate Recovery Program in Texas.

This form is used for notifying the State of Texas about community care services being provided.

This Form is used for creating a budget for the purchase of services in the state of Texas.

This form is used for assessing eligibility for community care services for the aged and disabled in the state of Texas.

This form is used for applying, verifying eligibility, or monitoring community care services in Texas.

This document summarizes the discussions and decisions made during a risk management team meeting in Texas. It provides a brief overview of the meeting's outcome.

This form is used for adding additional information to the Needs Assessment form in the state of Texas.

This form is used for authorizing the release of medical information in the state of Texas.

This form is used for community care intake in Texas. It is used to collect information about individuals seeking community care services.

This form is used for reporting the aggregate data of OAA NSIP eligible meals in Texas.

This form is used for screening nursing facility diversion slots in Texas for community care intake.

This document is used for registering and tracking interest in Texas.

This form is used for notifying conflicts of interest in the state of Texas.

This form is used for acknowledging contributions made in Texas.

This document is used for recording service delivery information with written narrative or summary in the state of Texas. It helps track and document the details of services provided.

This form is used for recording transportation log for supported home living and community support services in Texas.

This form is used for requesting prior approval in Texas for adaptive aid or minor home modifications.

This form is used for conducting entrance conferences and checklists during complaint investigations in the state of Texas.

This form is used for nursing facilities in Texas to provide palliative care for patients. It helps ensure that patients receive appropriate treatment and support during end-of-life care.

This form is used for assessing a person's ability to take care of themselves and manage their finances. It is specific to the state of Texas.

This Form is used for authorizing community care services in Texas. It allows individuals to access the necessary care and support services they need.

This document is used for recording the service delivery record for respite care in the state of Texas.

This form is used for outlining the rights and responsibilities of clients in the state of Texas.

This document is for planning the long-term care for children and young people under 22 years of age in Texas.

This Form is used for authorizing the disclosure of medical information in Texas.

This form is used for requesting a waiver for service in Texas.