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This version of the form is not currently in use and is provided for reference only. Download this version of
Form 3617
for the current year.
Form 3617 Request for Transfer of Waiver Program Services - Texas
What Is Form 3617?
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 3617?
A: Form 3617 is a document used to request the transfer of waiver program services in Texas.
Q: What is a waiver program?
A: A waiver program is a program that provides additional services and supports for individuals with disabilities who would otherwise need to live in an institution.
Q: Who can use Form 3617?
A: Form 3617 can be used by individuals who are currently receiving waiver program services and wish to transfer those services to a different provider or location.
Q: How do I fill out Form 3617?
A: To fill out Form 3617, you will need to provide information about yourself, your current waiver program services, and the provider or location you wish to transfer to.
Form Details:
- Released on October 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 3617 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
Download Form 3617 Request for Transfer of Waiver Program Services - Texas
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