10801
This Form is used for a provider to assign themselves as an appellant in Texas.
This form is used for notifying individuals in Texas about their ineligibility for a specific purpose or benefit.
This form is used for reporting self-employment income in the state of Texas.
This Form is used for employment verification in the state of Texas.
This form is used for submitting an end of year report in the state of Texas. It is necessary to provide financial and other relevant information for record-keeping purposes.
This Form is used for lodging complaints related to the Home and Community Based Services for Adult Mental Health in Texas.
This form is used for requesting state assistance funds in Texas, with a 90 percent funding rate.
This form is used for reporting a general physical examination in Texas. It allows healthcare professionals to document and communicate the results of a patient's overall physical health.
This document is used for a comprehensive evaluation of a person's hearing to determine the need for rehabilitation services in the state of Texas.
This form is used for reporting the results of a cardiac evaluation in the state of Texas.
This Form is used for requesting a waiver and agreement for modifying a residential site in Texas.
This form is used for notifying individuals about optional health care services in Texas.
This form is used for reporting medical information related to a disability caused by cancer in the state of Texas.
This form is used for reporting complaints and inquiries related to purchased services contracts on a monthly basis in Texas. It provides a way to track and address any issues or concerns raised by the public regarding these contracts.
This document is a quarterly program performance report for the state of Texas. It provides information and data on the performance of various programs in Texas.
This form is used for reporting program income on a quarterly basis in the state of Texas.
This form is used for reporting dental information in the state of Texas. It is used to provide details about dental treatments, diagnoses, and other relevant information.
This form is used for evaluating end-stage renal disease in Texas. It is a medical evaluation form for individuals with kidney failure.
This form is used for reporting final expenditures in Texas. It is used to provide a detailed breakdown of all expenses incurred during a specific period of time.
This form is used for the renewal of abortion facility licenses in the state of Texas.
This document is used for reporting quarterly financial information and analysis for a base/operational grant in the state of Texas.
This form is used for creating an inventory list of equipment in the state of Texas. It helps organizations keep track of the equipment they own.
This form is used for recording and sharing surgical and treatment recommendations in the state of Texas.
This Form is used for reporting personnel activity in the state of Texas.
This Form is used for reporting the closure of a chemical dependency treatment facility in Texas.
This type of document is used for renewing an ambulatory surgical center license in Texas.
This form is used for applying for an ambulatory surgical center license in the state of Texas.
This form is used for submitting emergency/disaster notifications in Texas. It helps in providing important information about emergencies or disasters to the relevant authorities.