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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 3641-A
for the current year.
Form 3641-A Alzheimer's Disclosure Statement for Nursing Facilities - Texas
What Is Form 3641-A?
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 3641-A?
A: Form 3641-A is the Alzheimer's Disclosure Statement for Nursing Facilities in Texas.
Q: What is the purpose of Form 3641-A?
A: The purpose of Form 3641-A is to disclose information about the services provided to individuals with Alzheimer's disease or related disorders in nursing facilities in Texas.
Q: Who needs to complete Form 3641-A?
A: Nursing facilities in Texas that provide services to individuals with Alzheimer's disease or related disorders need to complete Form 3641-A.
Q: What information is included in Form 3641-A?
A: Form 3641-A includes information about the facility's policies, care practices, and staff training related to Alzheimer's disease or related disorders.
Form Details:
- Released on November 1, 2004;
- 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 3641-A by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
Download Form 3641-A Alzheimer's Disclosure Statement for Nursing Facilities - Texas
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