Texas Health and Human Services Forms

This document provides information about the rights and responsibilities of individuals receiving Family Care, Community Attendant Services, and Primary Home Care in Texas. It serves as an attachment to Form 2307.

This form is used for releasing client information in the state of Texas.

This form is used for assessing the provider and adult foster care homes in Texas.

This form is used for conducting a consumer satisfaction interview for the Consumer Directed Services program in Texas. It is an addendum to Form 2314-C.

This form is used for conducting the orientation checklist for the Adult Foster Care Program in Texas. It ensures that all necessary information and requirements for the program are met by the caregivers and participants.

This Form is used for measuring customer satisfaction and monitoring service in Texas.

This form is used for conducting a records check through the Texas Department of Family and Protective Services (DFPS). It is typically required for various purposes, such as background checks for employment or licensing in fields involving the care of children or vulnerable populations in Texas.

This form is used for conducting health inspections at adult foster homes in Texas. It ensures that these homes meet the required standards of health and safety for the residents.

This document is used for requesting authorization for habilitation coordination services in Texas.

This form is used for requesting a fair hearing in Texas. If you have a dispute with a government agency or program and want to appeal their decision, you can use this form to request a fair hearing.

This Form is used for conducting a checklist inspection of assisted living facilities in Texas.

This form is used for conducting regulatory inspections of long-term care facilities in Texas. It helps the inspection team gather and document important information about the facility's compliance with regulations and standards.

This form is used for requesting a fair hearing in Texas for specialized services related to preadmission screening and resident review (PASRR). It allows individuals to appeal decisions made regarding their access to specialized services.

This form is used for certifying Alzheimer's care providers in the state of Texas. It is a checklist that ensures caregivers meet the necessary requirements for providing specialized care to individuals with Alzheimer's disease.

This Form is used for conducting a life safety code checklist for Type A&B assisted living facilities in Texas. It helps ensure that these facilities meet the required safety standards outlined in the Texas Administrative Code Section 92.61.

This document is used for conducting background checks on potential caregivers in Texas.

This Form is used for conducting a life safety code checklist for small type A facilities in Texas, as required by 40 Tac Section 92.61.

This form is used for conducting a life safety code checklist for small Type B assisted living facilities in Texas. It helps ensure that these facilities comply with the necessary safety regulations.

This form is used for assessing and approving service plans for adult foster care in Texas.

This Form is used for conducting a life safety code checklist for large assisted living facilities in Texas. It helps ensure compliance with safety standards and regulations.

This form is used for conducting a life safety code checklist for large type A assisted living facilities in Texas. It helps ensure that these facilities comply with the safety regulations specified in 40 Tac Section 92.61.

This form is used for conducting life safety code checklists for small assisted living facilities in Texas. It is based on Section 92.62 of the Texas Administrative Code.

This document is used to complete a life safety code checklist for large assisted living facilities in Texas. It provides guidelines and regulations for ensuring the safety of residents and compliance with 26 Tac Section 553.62.

This Form is used for conducting initial inspections of assisted living facilities in Texas. It is used to ensure compliance with the Life Safety Code and includes a checklist of requirements that must be met.

This form is used for conducting a life safety code checklist to obtain Alzheimer's certification in Texas. It is a requirement under section 40 Tac 92.53.

This form is used for conducting an initial life safety code checklist for day activity and health services facilities in Texas. It ensures compliance with safety regulations and measures in the facility.

This form is used for evaluating vehicles for the Community Living Assistance and Support Services (CLASS) and Deaf Blind With Multiple Disabilities (DBMD) programs in Texas. It helps determine if a vehicle is suitable for transporting individuals with disabilities.

This form is used for physicians in Texas to provide a recommendation for the length of stay in a nursing facility for a patient.

This document is used for requesting medical data in Texas.

This form is used for Child Placing Agencies in Texas to conduct a risk evaluation, as required by the law. It involves submitting an affidavit to provide information about the safety and well-being of a child in their care.