TX HHS Form 3067. Appointment Notice

The TX HHS Form 3067, Appointment Notice, helps individuals determine their eligibility for assistance through the County Indigent Health Care Program (CIHCP). This form is typically used in situations where an individual needs to apply for healthcare services or re-apply due to changes in their circumstances. The form is usually filled out by the applicant themselves.

The Appointment Notice requires the individual to provide specific information, including identification, proof of county residence, and proof of resources and household income. Additionally, individuals are expected to bring relevant documents, such as receipts for child care expenses and Social Security numbers (if available), to their scheduled interview. The notice also emphasizes the importance of attending the interview to review one's case and determine continued eligibility for assistance.

To prepare for an appointment, it is essential to gather all required information and documentation. Key points to keep in mind include:

• Identification: driver license or voter registration card
• Proof of county residence: mail, voting records, or official identification
• Proof of resources: checking or savings account statements, tax statements, or stocks and bonds
• Proof of household income: paycheck stubs, employer letters, or self-employment records
• Proof of child care expenses: receipts for payment
• Social Security numbers (if available) for all household members