TX HHS Form 5156. Referral Checklist

The TX HHS Form 5156, Referral Checklist, is a crucial tool for ensuring that necessary information is gathered and submitted to facilitate the guardianship process. This form helps solve the problem of incomplete or missing data by providing a comprehensive checklist of required documents and information.

The form is typically used in situations where a referral for guardianship is being made, whether it's an initial referral or a successor guardianship. The contractor or representative agent fills out the form to provide a complete packet of information, including the Contractor's Referral Form (Form 5013), Certificate of Medical Evaluation (CME), and other relevant documents. Key features of the form include the required information for both initial and successor referrals, as well as the responsibility to return incomplete packets to the Guardianship Supervisor.

The completed referral packet is then submitted to the Guardianship Supervisor, who reviews it to ensure that all necessary information has been provided. The form's checklist format helps streamline the process by identifying any missing or incomplete information at a glance. By using this form, contractors and representative agents can help ensure that referrals are processed efficiently and effectively.

• The TX HHS Form 5156 is used for both initial and successor guardianship referrals.
• The form requires a comprehensive packet of information, including the Contractor's Referral Form (Form 5013) and other relevant documents.
• The contractor or representative agent fills out the form to provide a complete referral packet.