TX HHS Form 3029. Application for Program Benefits

The TX HHS Form 3029, "Application for Program Benefits," is a crucial document that helps individuals apply to the Primary Health Care (PHC) Program and the Title V Maternal & Child Health Fee-For-Service (Title V MCH FFS) Program. This form should be used by those seeking program benefits from these government programs.

This application requires applicants to provide essential information, including their name, sex, date of birth, race or ethnicity, and contact details. Additionally, the form asks about household members, including children under 18 years old, and whether any household members have special circumstances that may affect their inclusion in the household. The form also inquires about immediate medical or dental needs and whether applicants are veterans.

The TX HHS Form 3029 is an important tool for individuals seeking program benefits from the PHC Program and Title V MCH FFS Program. By completing this application, individuals can ensure they have provided all necessary information to support their eligibility for these programs.