TX HHS Form 1505. Request for Due-Process Hearing and/or Mediation

The TX HHS Form 1505, Request for Due-Process Hearing and/or Mediation, is a crucial document that helps individuals contest determinations or decisions made by Texas Health and Human Services (HHS) staff. This form is typically used in situations where an individual's eligibility for vocational rehabilitation services, independent living services, or further services is being contested.

This form requires participants to provide specific information, including their name, social security number, street address, city and ZIP code, telephone number, email address, and date of the petition. The participant must also specify the nature of their disability and the determination or decision they are contesting. Key features of this form include the required information on the participant's individual circumstances and the specific procedures for requesting a due-process hearing and/or mediation.

By completing and submitting this form, participants can initiate the process to resolve disputes with HHS staff regarding their eligibility for services or the quality of those services. The form must be mailed or delivered to the HHS Hearings Coordinator at 4800 N. Lamar Suite 300, Austin, Texas 78756-3178. Key points and requirements include:

• Requesting a due-process hearing and/or mediation to contest determinations or decisions made by HHS staff.
• Providing required information about the participant's individual circumstances and the specific determination or decision being contested.
• Mailing or delivering the completed form to the HHS Hearings Coordinator.