TX HHS Form 3202. Application to Operate or Close a Faith-Based Chemical Dependency Treatment

The TX HHS Form 3202, Application to Operate or Close a Faith-Based Chemical Dependency Treatment, is used by religious organizations to notify the Texas Health and Human Services Commission (HHSC) of their intention to open or close a faith-based chemical dependency treatment program. This form helps solve the problem of registering for exemption from licensure under Texas Health and Safety Code Chapter 464, Subchapter C.

The application requires key information such as the organization's name, federal tax ID number, mailing address, and authorized representative contact details. Section 2 of the form is particularly important, as it involves the authorized representative's attestation and signature, confirming that the program meets specific requirements for exemption, including being conducted by a religious organization and not providing medical care or services.

This form should be used when opening or closing a faith-based chemical dependency treatment program. It is essential to complete and submit this application in accordance with the specified requirements and conditions, as outlined in Section 2 of the form. The completed application can be submitted by email to [email protected] or by mail to the Texas Health and Human Services Commission Health Facility Licensing Unit.