Form 3054 Primary Home Care Service Delivery Record - Texas

Form 3054 Primary Home Care Service Delivery Record - Texas

What Is Form 3054?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 3054?
A: Form 3054 is the Primary Home Care Service Delivery Record used in Texas.

Q: What is Primary Home Care?
A: Primary Home Care is a program in Texas that provides non-medical assistance to individuals who have functional limitations in their daily activities.

Q: Who can use Form 3054?
A: Form 3054 is used by providers of Primary Home Care services in Texas.

Q: What is the purpose of Form 3054?
A: Form 3054 is used to document the delivery of services and the care provided to an individual receiving Primary Home Care.

Q: What information is recorded on Form 3054?
A: Form 3054 records information such as the date and time of service, type of service provided, and the caregiver's signature.

Q: Do I need to submit Form 3054?
A: Form 3054 does not need to be submitted, but it should be kept as a record of services provided.

Q: Can I use Form 3054 for other types of home care services?
A: Form 3054 is specifically designed for Primary Home Care services in Texas, but some information may be applicable to other types of home care services.

Q: Is Form 3054 mandatory?
A: Form 3054 is required for providers participating in the Primary Home Care program in Texas.

Q: Who should I contact for more information about Form 3054?
A: For more information about Form 3054, you can contact the Texas Health and Human Services Commission.

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Form Details:

  • Released on July 1, 2015;
  • The latest edition provided by the Texas Health and Human Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form 3054 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.

Download Form 3054 Primary Home Care Service Delivery Record - Texas

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