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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.
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.
