TX HHS Form 3214. Chemical Dependency Treatment Facility Satellite Site Notification

The TX HHS Form 3214, Chemical Dependency Treatment Facility Satellite Site Notification, is a crucial document for chemical dependency treatment facilities operating satellite sites in Texas. This form helps solve the problem of notifying the relevant authorities about the establishment or closure of a satellite site, ensuring compliance with state regulations.

This notification form requires key information such as facility and satellite site details, including physical address, setting, and population served. It also includes sections for signature and attestation, confirming that the satellite site operates under the supervision of a licensed outpatient care facility and complies with relevant Texas laws and codes.

The TX HHS Form 3214 should be used when a chemical dependency treatment facility establishes or closes a satellite site in Texas. The form must be completed and signed by the Chief Executive Officer or Facility Contact, and submitted to the Health Facility Licensing department at [email protected] within 30 calendar days of any changes to the information provided.