TX HHS Form 0006. Service Provider Printed Forms Order

Form 0006, titled “Service Provider Printed Forms Order,” is designed to help service providers in Texas request printed forms free of charge. It ensures that organizations can obtain the necessary documents for assisting clients with benefits and services efficiently.

Purpose and Overview

This form allows service providers to order multiple Texas state forms, including applications for Medicaid, Texas Women’s Health Program brochures, and Emergency Medical Services certifications. Providers can specify the quantity of each form needed, with a minimum of 50 and a maximum of 2,000 copies per order.

Who Can Use This Form

Only authorized service providers in Texas may submit this order. It is intended for organizations that assist residents with state benefits or health-related services. Individual citizens should not use this form directly.

Key Sections of the Form and Expert Explanations

Contact Information

Service providers must provide the contact person’s phone number and facility name. Accuracy is essential to ensure timely delivery of ordered forms. Common mistake: providing a PO Box instead of a physical address, which delays shipment.

Address Details

Include street address, city, state, and ZIP code. Texas state regulations require a physical delivery address for all forms; shipments to PO boxes are not accepted.

Form Selection and Quantity

List each requested form with its form number and the quantity desired. Remember:

• Minimum order per form: 50 copies
• Maximum order per form: 2,000 copies

Failing to respect quantity limits can result in order rejection.

Submission Instructions

After completing the order, click the "Submit Form by Email" button at the bottom. Allow up to four weeks for delivery. Common mistake: neglecting the submit button, which leaves the order unprocessed.

Practical Tips for Filling the Form

• Double-check all contact information before submission.
• Ensure quantities fall within the allowed range.
• Use a valid physical address — PO Boxes are not accepted.
• Keep a copy of the completed form for your records.

Examples of Real-Life Use Cases

• A community health clinic needs multiple copies of the Texas Women’s Health Program brochures to distribute to clients at a local event.
• A social service agency orders the H1200 Application for Assistance forms to assist elderly residents applying for benefits under Texas programs.
• An emergency medical services organization requests certification forms for staff and authorization to release information forms for patients.
• A bilingual outreach program orders Spanish-language forms to ensure non-English-speaking clients can complete applications accurately.

Required Documents

Generally, no additional documents are required to submit Form 0006 itself. However, the ordered forms will later require standard documentation for their respective applications (proof of income, identification, medical records, etc.).

Legal and Regulatory Context

Form 0006 is mandated by Texas Health and Human Services regulations. It ensures that service providers have access to official state forms for administering benefits and healthcare programs in compliance with state law.

Frequently Asked Questions (FAQ)

Who can submit Form 0006?

Only authorized Texas service providers may submit this form.

Is there a minimum or maximum order quantity?

Yes, each form must be ordered in at least 50 copies and no more than 2,000 copies.

Can I use a PO Box for delivery?

No, only a physical address is accepted.

How long does it take to receive the forms?

Allow up to four weeks for delivery after submission.

Are any forms no longer available?

The Food Stamps and TANF applications (H1010) are no longer available through this service.

Do I need to attach documents with this order?

No attachments are required for submitting the order form itself.

What happens if I submit the form incorrectly?

Incorrect submissions may delay processing or cause the order to be rejected.

Micro-FAQ (Short Answers for Quick Reference)

• Purpose: Order Texas state forms for service providers.
• Who files: Authorized service providers in Texas.
• Deadline: No strict deadline; forms are processed upon submission.
• Attachments: None required.
• Submitted to: Via the "Submit Form by Email" button.

Related Forms

• H0900 Texas Women's Health Program [brochure]
• H1113 Application for Prior Medicaid Coverage
• H1200 / H1200-S / H1200-EZ Application for Assistance – Your Texas Benefits
• H1858 / H1858-S Items We Might Need from Anyone on Your Case
• H3037 Report of Pregnancy forms
• H3038 Emergency Medical Services Certification forms
• 8001 / 8001-S Medicaid Estate Recovery Program Receipt Acknowledgement

Form Details / Final Information

• Form Name: Service Provider Printed Forms Order
• Form Number: 0006
• Region: Texas
• Date of Revision: August 2021-E