TX HHS Form 3055. Physician's Orders (DAHS)

The TX HHS Form 3055, Physician's Orders (DAHS), is a crucial document used to facilitate the provision of Day Activity and Health Services (DAHS) for adults with chronic medical conditions. This form helps healthcare professionals outline the necessary orders and instructions for DAHS program providers, ensuring that eligible individuals receive the required services.

The form consists of four main sections: Person's Information, Chronic Medical Diagnosis(es), Functional Limitations Related to Medical Diagnoses, and Special Diet Instructions, Notes, Comments. The Physician's Orders (DAHS) must include essential details such as the individual's name, date of birth, DAHS program provider information, and corresponding ICD-10 codes for chronic medical diagnoses. This form is typically used when an adult with a chronic medical condition requires day care services to manage their health.

The TX HHS Form 3055, Physician's Orders (DAHS), is an essential tool for healthcare professionals and DAHS program providers to ensure that adults with chronic medical conditions receive the necessary support and care. By completing this form, healthcare professionals can provide clear instructions for DAHS program providers, enabling them to deliver high-quality services that meet the unique needs of each individual.