TX HHS Form 1587. Financial Management Services Agency (FMSA) First Consumer Fax Cover Sheet

The TX HHS Form 1587, Financial Management Services Agency (FMSA) First Consumer Fax Cover Sheet, is used to facilitate the enrollment or transfer process for individuals participating in waiver program services. This form helps solve the problem of ensuring that all necessary information is provided and received by the correct parties.

This form requires key information such as date, recipient contact details, and program provider information. It also includes a confidentiality notice, emphasizing the importance of protecting sensitive data. The form must be completed by the FMSA or TxHmL Program Provider, who will typically fill out this document to initiate or transfer services.

The key features of this form include:

• Required information for enrollment or transfer
• Contact details for program providers and recipients
• Confidentiality notice emphasizing the protection of sensitive data