TX HHS Form 5056. Application for Services

The TX HHS Form 5056, Application for Services, is a comprehensive tool designed to help individuals access Comprehensive Rehabilitation Services (CRS). This form serves as the initial point of contact for those seeking assistance with living more independently.

This application requires key information, including social security number, date of birth, and email address. It also asks about potential needs for reasonable accommodations, language preferences, and medical or psychological records that can be brought to the initial case note. The form explicitly mentions conditions such as traumatic brain injury (TBI) and requests permission to request these records.

The TX HHS Form 5056 should be used by individuals seeking CRS services to help them live more independently. This application is particularly useful for those who have experienced a change in their condition or need assistance with daily living activities. By completing this form, individuals can initiate the process of receiving comprehensive rehabilitation services and take the first step towards achieving greater independence.