TX HHS Form 1743. Transfer Information TxHLP

The TX HHS Form 1743 Transfer Information TxHLP is a crucial document that facilitates the transfer of Consumer Directed Services (CDSA) information between individuals or entities. This form helps resolve issues related to service continuity and ensures a seamless transition of support services for home living and respite care.

This form requires essential information from both the transferring party and the receiving party, including legal entity names, telephone numbers, contract numbers, and county codes. The form also outlines specific details about the services being transferred, such as the type of support (home living or respite) and the number of service units involved. Additionally, it includes spaces for signatures from both parties to confirm the accuracy of the information.

Key features of this form include:

• The transfer of CDSA services between individuals or entities
• The provision of essential information about the services being transferred
• The requirement for signatures from both parties to confirm the accuracy of the information
• The facilitation of service continuity and transition