PDF
Word
This version of the form is not currently in use and is provided for reference only. Download this version of
Form 3055
for the current year.
Form 3055 Day Activity and Health Services (Dahs) Physician's Orders - Texas
What Is Form 3055?
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 3055?
A: Form 3055 is the Day Activity and Health Services (DAHS) Physician's Orders form in Texas.
Q: What is the purpose of Form 3055?
A: The purpose of Form 3055 is to provide physician's orders for individuals receiving Day Activity and Health Services in Texas.
Q: Who uses Form 3055?
A: Form 3055 is used by physicians or other authorized healthcare professionals in Texas.
Q: What is Day Activity and Health Services (DAHS)?
A: Day Activity and Health Services (DAHS) is a program in Texas that provides daytime care and activities for individuals with disabilities or chronic conditions.
Q: What information is included in Form 3055?
A: Form 3055 includes information such as the individual's name, healthcare provider's information, specific orders related to medications, treatments, or activities, and the physician's signature.
Q: Is Form 3055 specific to Texas?
A: Yes, Form 3055 is specific to Texas and is used within the state's Day Activity and Health Services program.
Form Details:
- Released on June 1, 2017;
- 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 3055 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
Download Form 3055 Day Activity and Health Services (Dahs) Physician's Orders - Texas
1
2
