TX HHS Form 2059. Summary of Client's Need for Service

The TX HHS Form 2059, "Summary of Client's Need for Service", helps healthcare providers and social workers assess the needs of clients who require assistance with daily living activities. This form is typically used in situations where individuals are unable to perform certain tasks due to physical or mental limitations.

This form requires information about the client's functional limitations, including conditions that cause these limitations, as well as their home environment and any assistive devices they may use. The form also asks about the client's living arrangement and the role of family or caregivers in meeting their needs. Additionally, it inquires about common household tasks being purchased and the reason for these purchases.

• This form is used to identify the specific problems that impact service delivery and to determine the necessary services required by the client.
• It helps healthcare providers and social workers develop a comprehensive plan to meet the client's needs, including identifying other services they may be receiving or being referred for.