TX HHS Form 1017. Burial or Cremation Assistance Registry Application

The Texas Health and Human Services (HHS) Burial or Cremation Assistance Registry Application Form 1017 allows funeral homes, cemeteries, and private nonprofit organizations to register for inclusion on the registry. This form enables these organizations to provide financial or other assistance for the transportation, cremation, or burial of embryonic or fetal tissue remains.

The purpose of this application is to ensure that organizations listed on the registry are willing to provide the necessary services under Health and Safety Code Section 697.005 and 25 Texas Administrative Code Section 138.8. By submitting this form, organizations acknowledge their commitment to providing these services and agree to maintain accurate information in the registry.

This application is intended for use by funeral homes, cemeteries, and private nonprofit organizations seeking to register on the Burial or Cremation Assistance Registry. The Texas HHS Commission issues this form, which must be submitted with a printed name and title, signature, and date. Organizations may submit their applications by email.