This version of the form is not currently in use and is provided for reference only. Download this version of Form 3621 for the current year.
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.
Q: What is Form 3621?
A: Form 3621 is the Individual Plan of Care for the Community Living Assistance and Support Services (CLASS) and Community First Choice (CFC) programs in Texas.
Q: What are the CLASS and CFC programs?
A: CLASS and CFC are programs in Texas that provide community living assistance and support services to eligible individuals.
Q: What is the purpose of Form 3621?
A: Form 3621 is used to develop an individualized care plan for participants in the CLASS and CFC programs.
Q: Who completes Form 3621?
A: Form 3621 is completed by a case manager or other authorized person who assesses the participant's needs and develops the care plan.
Q: What information is included in Form 3621?
A: Form 3621 includes information about the participant's medical history, functional limitations, support needs, and goals for community living.
Q: How is Form 3621 used?
A: Form 3621 is used to guide the provision of support and services to the participant, ensuring they receive the appropriate care and assistance.
Q: Can participants and their families provide input on Form 3621?
A: Yes, participants and their families are encouraged to provide input and preferences to ensure the care plan reflects their needs and goals.
Q: Is Form 3621 confidential?
A: Yes, Form 3621 contains confidential personal and medical information that is protected by privacy laws.
Q: What should participants do if they have changes to their care needs?
A: Participants should notify their case manager or program administrator if they experience changes in their care needs or goals.
Form Details:
Download a fillable version of Form 3621 by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.