TX HHS Form 3068. Request for Information

The TX HHS Form 3068, Request for Information, is a crucial document that helps individuals determine their eligibility for assistance through the County Indigent Health Care Program (CIHCP). This form is typically used in situations where an application for assistance is incomplete, requiring additional information to proceed with the evaluation process.

This form requires applicants to provide specific information, including their mail address, federal income tax return, and identification documents such as a Texas driver's license or official ID. Additionally, applicants may need to provide proof of self-employment, social security benefits, or other forms of assistance. The form also includes spaces for applicants to list any other relevant items that may be required.

To complete the application process, applicants must provide all necessary information and documentation as specified on the form. Failure to do so may result in incomplete applications and delayed processing times. Key points to note include:

• The form is used for determining eligibility for assistance through the CIHCP.
• Applicants are required to provide specific information and documentation.
• Incomplete applications may be returned, delaying the evaluation process.