10801
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.
This form is used for requesting medical evidence in Texas.
This form is used for emergency dental services in the state of Texas. It provides a way for individuals to request and access dental care in urgent situations.
This form is used for requesting rehabilitative services in Texas. It enables individuals to access the necessary support and resources to aid in their rehabilitation and recovery process.
This document is used for physician certification in the state of Texas. It verifies the qualifications and credentials of a physician.
This document is used for submitting an application acknowledgment in the state of Texas.
This form is used for assessing the emergency preparedness of assisted living facilities in Texas. It includes a checklist of items to ensure the facility is ready to respond to emergencies effectively.
This form is used for applying for a treatment decision on behalf of a patient by a surrogate consent committee in the state of Texas.
This form is used for authorizing a third party to provide attestation in the state of Texas.
This form is used in Texas to certify the need for major medical treatment.
This Form is used for certifying the need for major dental treatment in Texas.
This Form is used for recording information about licensed and registered caregivers, assistants, substitutes, and household members in Texas.
This form is used for certifying the need for psychoactive medication treatment in the state of Texas. It is required to demonstrate the necessity of medication for individuals undergoing psychiatric treatment.
This form is used for creating a list of persons who will be notified about a Surrogate Consent Committee (SCC) hearing in Texas.
This form is used to provide notification of a Surrogate Consent Committee (SCC) hearing in Texas.
This form is used for individuals in Texas who want to waive their right to be a surrogate decision maker.
This Form is used for collecting data related to the Surrogate Decision Making Program in Texas.
This Form is used for notifying an individual in Texas of the denial of eligibility.
This document is used for responding to an audit of an eligible hospital in Texas.