TX HHS Form 3681-B. Community Services Contract Application Addendum B - Adult Foster Care Provider Questionnaire

The Adult Foster Care Provider Questionnaire, TX HHS Form 3681-B Addendum B, is a crucial document for adult foster care providers in Texas. This form helps solve the problem of ensuring that adult foster care providers have the necessary information to provide quality care to their clients. The questionnaire is typically used by adult foster care providers who need to apply for or renew their contract with the Texas Health and Human Services (HHS) agency.

The form requires applicants to provide identifying information, including name, social security number, mailing address, and telephone number. Additionally, applicants must describe any significant health problems or disabilities they may have. The questionnaire also asks about education, employment, and income, as well as interests and hobbies. Each question must be answered fully before the application can be accepted.

Key features of this form include the requirement for complete answers to each question, as well as the need to provide detailed information about health status and any significant health problems or disabilities. By completing this questionnaire, adult foster care providers can demonstrate their ability to provide quality care to their clients and meet the necessary requirements for a contract with the Texas HHS agency.

• This form is used by adult foster care providers in Texas who need to apply for or renew their contract with the Texas Health and Human Services (HHS) agency.
• The questionnaire requires applicants to provide identifying information, describe any significant health problems or disabilities, and provide details about education, employment, and income.