TX HHS Form 3627. Specialized Nursing Certification

The Specialized Nursing Certification Form 3627 helps healthcare professionals determine the need for specialized nursing care for individuals with specific medical conditions. This form is typically filled out by registered nurses (RNs) to certify that a participant in the Deaf Blind with Multiple Disabilities Program requires specialized nursing due to certain criteria.

The form requires the RN to check at least one of the following criteria: the program participant uses a ventilator or requires tracheostomy care at least once a day. The latter involves cleansing, dressing, and suctioning of the tracheostomy. By completing this form, healthcare professionals can ensure that participants receive the necessary specialized nursing care to meet their unique needs.

• The Specialized Nursing Certification Form 3627 is used to establish the need for specialized nursing care in situations where program participants require ventilator support or tracheostomy care.