TX HHS Form 3031. Children with Special Health Care Needs (CSHCN) Program Application

The TX HHS Form 3031, Children with Special Health Care Needs (CSHCN) Program Application, is a crucial document for individuals seeking assistance from the Texas Health and Human Services (HHS) CSHCN program. This form helps families access essential healthcare services and support for their children with special needs.

The application requires applicants to provide personal information about the child needing assistance, including name, social security number, sex, and citizenship status. Additionally, applicants must provide proof of birth date and residency, which can be demonstrated through various documents such as a birth certificate, passport, or utility bill. The form also asks for contact information, language preferences, and income sources.

Key features of the application include the requirement to list all sources of income and the pay cycle for each source. This information helps the CSHCN program understand the applicant's financial situation and provide targeted support. By completing this form, families can access a range of services, including medical care, therapy, and equipment assistance.

• The application is typically filled out by parents or guardians seeking assistance for their child with special healthcare needs.
• The form requires proof of birth date and residency to verify the applicant's identity and eligibility.
• The application asks about income sources, including self-employment, employment, and government benefits.