Texas Health and Human Services Forms

This form is used for requesting an exception to the Information Security Risk policy in Texas.

This form is used for creating an External Entity Information Security Plan of Action and Milestone in the state of Texas. It helps to outline the steps and timeline for addressing security issues related to external entities.

This document provides information about authorized electronic monitoring in convalescent centers in Texas.

This Form is used to report a potential privacy or security incident that has occurred in the state of Texas. It helps to ensure that proper measures are taken to address and prevent any further breaches.

This Form is used for requesting authorized electronic monitoring in Texas.

This form is used for obtaining consent from a roommate in Texas for authorized electronic monitoring of a shared living space. It outlines the terms and conditions of the monitoring arrangement to ensure privacy and legal compliance.

This form is used for faxing the Texas Home and Community-Based Services (TxHmL) and Home and Community-Based Services (HCS) cover sheet.

This Form is used for requesting an emergency rule exception for End Stage Renal Disease (ESRD) facilities in Texas.

This form is used for conducting a review of Texas residents with mental illness or dementia to ensure appropriate care and treatment.

This form is used for the Pre-admission Screening and Resident Review (PASRR) evaluation summary report in the state of Texas.

This Form is used for discussing specialized services for the LMHA-PASRR program in Texas.

This form is used for requesting authorization for electronic monitoring in Texas.

This form is used for acknowledging responsibility for reporting abuse, neglect, exploitation, and reasonable suspicion of crime in Texas.

This form is used for acknowledging responsibility for reporting abuse, neglect, exploitation, and reasonable suspicion of crime in Texas.

This Form is used for verifying railroad retirement benefits in the state of Texas.

This form is used for requesting information related to Medicare Advantage coordination in the state of Texas.

This form is used for verifying the retirement benefits of railroad workers in Texas.

This Form is used for determining the status of a caregiver in Texas. It helps assess the eligibility for certain benefits or programs.

This type of document is used for completing a questionnaire about the caregiver's condition in Texas.

This form is used for transferring case records in Texas.

This form is used for requesting authorization for the medication Synagis through the Texas Vendor Drug Program for Medicaid recipients in Texas.

This Form is used for providing information and checklist for filing Form 1040 CFC Non-waiver Packet in Texas.

This Form is used for post-move monitoring in Texas.

This form is used for rejecting the coordination of habilitation services in Texas.

This Form is used for refusing the habilitation coordination services in Texas.

This form is used for documenting the initial choice of a provider for Home and Community Based Services (HCS) or Texas Home Living (TxHmL) program in Texas.

This form is used for nursing facilities or crisis diversion plans in the state of Texas. It aids in outlining a plan for care and diversion during times of crisis or emergency situations.

This form is used for requesting a determination of intellectual disability in the state of Texas. It is used to assess whether an individual meets the criteria for intellectual disability as defined by law.