TX HHS Form 2110. Community Care Intake

The Texas Health and Human Services (HHS) Form 2110, Community Care Intake, is a crucial document used to collect essential information about individuals seeking services through the state's community care programs. This form serves as a comprehensive intake tool, gathering details on the individual's demographics, social security number, mailing address, and contact information.

The form also inquires about the individual's marital status, preferred language, and communication accommodations required. Additionally, it collects information on declared resources, including bank accounts, life insurance, and homestead property. The document further explores the individual's living arrangement, relationship with others, and Medicare enrollment status. This comprehensive data collection enables HHS to assess the individual's needs and provide appropriate services.

The Community Care Intake Form 2110 is designed to facilitate the intake process for individuals seeking assistance through Texas HHS programs. By providing a standardized format for collecting essential information, this form helps ensure that all necessary details are gathered efficiently and accurately. As such, it plays a critical role in supporting the delivery of vital services to those in need.