TX HHS Form 3594. Individual Plan of Care (IPC) Cover Sheet

The Individual Plan of Care (IPC) Cover Sheet, TX HHS Form 3594, is a crucial document that helps individuals with Deaf Blindness with Multiple Disabilities (DBMD) develop a personalized plan for their care. This form serves as an introduction to the comprehensive IPC process, outlining essential information and goals for the individual's program.

The IPC Cover Sheet requires specific details, including the individual's name, mailing and physical addresses, and contact information. It also includes space for providers to document their services, goals, and progress. This form is typically submitted to the Texas Health and Human Services Commission (HHSC) as part of the IPC packet.

• This form is used in conjunction with other documents, such as the Individual Plan of Care (IPC), to create a comprehensive care plan for individuals with DBMD.
• The IPC Cover Sheet provides an overview of the individual's program, including their goals, services, and progress.