TX HHS Form 1204. Government Performance and Results Act (GPRA) Assessment Participant Information Sheet

The TX HHS Form 1204, Government Performance and Results Act (GPRA) Assessment Participant Information Sheet, is a crucial tool for collecting essential contact information from individuals receiving services that require GPRA assessments. This form helps ensure timely follow-up assessments by providing the necessary details to reach participants.

This form requires participants to provide their additional phone number and area code, email address, and optional secondary contact information. It also asks permission to leave a voicemail or state the name of the organization when making calls. The participant is responsible for informing HHS if any of this information changes before the follow-up assessment. Failure to reach the participant may result in contacting a friend or family member with their permission.

The form's purpose is to facilitate communication and ensure successful follow-up assessments. Key features include the collection of contact information, permission to leave voicemails or disclose organization names, and optional secondary contact details. By providing this information, participants can help HHS stay in touch and complete the assessment process efficiently.

• This form is used for individuals receiving services that require GPRA assessments.
• Participants are responsible for updating their contact information if changes occur before the follow-up assessment.