TX HHS Form 0702. Fax Cover Sheet for TxHmL and HCS

The Texas Home Living (TxHmL) and Home and Community-based Services (HCS) Fax Cover Sheet (Form 0702) is a crucial document for requesting transfers, continuations of suspension, terminations, or other actions related to waiver program services. Issued by the Texas Health and Human Services (HHS), this form serves as a comprehensive tool for service coordinators, local authorities, and other stakeholders involved in the TxHmL and HCS programs.

The Form 0702 requires specific information, including the date, number of pages, fax numbers, names, emails, and telephone numbers. It also necessitates the submission of supporting documents, such as Forms 3617, 3608, or 8582, depending on the type of request being made. The form emphasizes the importance of completing all data entry screens in the Client Assignment and Registration (CARE) System before faxing a request, unless otherwise instructed by HHSC.

This confidential communication is intended solely for the use of the indicated fax addressees. Any unauthorized disclosure, dissemination, distribution, copying, or other use of this form or attached documents is strictly prohibited. If received in error, the sender should be notified immediately, and all copies of the communication and attached documents should be destroyed.