TX HHS Form 2065-A. Notification of Community Care Services

The TX HHS Form 2065-A, Notification of Community Care Services, is a crucial document that helps solve the problem of notifying relevant parties about changes or updates in community care services. This form is typically used by caseworkers, social workers, or other professionals who need to inform individuals or organizations about eligibility, termination, suspension, or changes in community care services.

The form requires specific information, including notification of eligibility, ineligibility, termination, or suspension of services, as well as notifications of change and comments. It also includes a signature section for the HHSC caseworker and a date stamp. This document serves as a formal record of these important updates, ensuring that all parties are informed and aware of any changes.

Key features of this form include:

• Notification of eligibility or ineligibility for community care services
• Termination or suspension of services
• Notifications of change, including copayment adjustments
• A signature section for the HHSC caseworker and a date stamp