TX HHS Form 5872. Certification of Pre-Application Orientation

TX HHS Form 5872, "Certification of Pre-Application Orientation," is a crucial document that helps solve the problem of ensuring entities have completed the necessary pre-application orientation for various services. This form should be used when an entity is contracting to provide Community Living Assistance and Support Services (CLASS), Day Activity and Health Services (DAHS), or Primary Home Care/Family Care/Community Attendant Services (PHC/FC/CAS).

The form requires the Legal Name of Entity, Type or Print, to certify that they have read the Pre-Application Orientation Guide for the specific service(s) they are contracting to provide. The guide links provided in the text include CLASS, DAHS, and PHC/FC/CAS, which entities must access to complete their pre-application orientation.

This form is essential for entities seeking to provide these services, as it ensures they have completed the necessary orientation before proceeding with the application process. By using TX HHS Form 5872, entities can demonstrate compliance with the required pre-application orientation and move forward with confidence in their service provision.