TX HHS Form 3018. Administrator Licensing – Change in Contact Information

The TX HHS Form 3018, "Administrator Licensing – Change in Contact Information," is a crucial document for updating contact information with the Texas Health and Human Services Commission. This form helps licensed administrators notify the commission of any changes to their contact details, ensuring that they can be reached efficiently.

To complete this form, you will need to provide your new contact information, including administrator ID, phone number, email address, and operation name (if applicable). The "Work Area Code and Phone No." section is a required field. Note that any contact information provided on this form will be added to the Licensed Administrators Directory and made publicly visible.

Before submitting the completed form, please review the privacy statement, which can be found online at hhs.texas.gov/policies-practices-privacy#security. The form can be submitted by fax, email, or mail to Texas Health and Human Services Commission Administrator Licensing, MC 278-5, 3635 SE Military Dr., San Antonio, TX 78223 (fax: 512-934-9647, email: [email protected]).