TX HHS Form 4800-DA. 4800-D Addendum

The TX HHS Form 4800-D Addendum, also known as Form 4800-DA, is a supplementary document used to provide additional information about participants in a specific appeal process. This form helps solve the problem of gathering necessary details from multiple individuals involved in an appeal.

This addendum requires providing the name, organization and title, participant type, mailing address (including mail code if applicable), county, area code, and telephone number for up to 14 additional participants. Important sections include the individual's name, appeal ID number, and special accommodation requests. The form is commonly used in situations where multiple individuals are involved in an appeal process and need to provide additional information.

The TX HHS Form 4800-D Addendum should be used when additional participant information is required for a specific appeal process. This form helps ensure that all necessary details are gathered, facilitating the efficient processing of appeals.