TX HHS Form 3641. Alzheimer's Assisted Living Disclosure Statement

The TX HHS Form 3641, Alzheimer's Assisted Living Disclosure Statement, is a crucial document that helps individuals and families make informed decisions about care for loved ones with Alzheimer's disease or related disorders. This form is typically used by assisted living facilities in Texas to disclose the services they provide and how these services cater to the unique needs of residents with dementia.

The disclosure statement requires facilities to provide specific information, including their name, ID number, and contact details. Facilities must also indicate whether they have specialized units or secured areas for residents with Alzheimer's or dementia. This form is essential for individuals seeking care options that meet the special needs of loved ones with dementia, allowing them to compare facilities and services.

Key features of this form include the requirement for facilities to disclose their services and how they target the special needs of residents with dementia. Facilities must also provide copies of the disclosure statement to anyone requesting information on Alzheimer's or related dementia care. By completing this form, assisted living facilities in Texas can demonstrate their commitment to providing high-quality care and support for individuals with dementia.

• This form is required by facilities certified to provide care to residents with Alzheimer's disease and related disorders.
• Facilities must complete the disclosure statement according to the care and services they provide.
• The form provides a standardized format for individuals, families, and other interested persons to compare facilities and services.