TX HHS Form 8662. Related Conditions Eligibility Screening Instrument

The TX HHS Form 8662, Related Conditions Eligibility Screening Instrument, is a practical tool designed to help determine eligibility for individuals with related conditions. This form is typically filled out by healthcare professionals or social workers who need to assess an individual's functional abilities and major life activities.

The form consists of three sections: Applicant Data, Functional Criteria, and Major Life Activities. The first section collects basic information about the applicant, including name, sex, date of birth, and social security number. The second section evaluates the applicant's ability to perform various tasks, such as verbally or non-verbally communicating, acquiring knowledge, and transferring skills to new situations. The third section assesses major life activities, including self-direction, capacity for independent living, and eye-hand coordination.

The Related Conditions Eligibility Screening Instrument is used in situations where an individual's functional abilities need to be evaluated to determine their eligibility for certain services or programs. This form helps healthcare professionals and social workers identify areas of difficulty and provide targeted support and accommodations. Key features of the form include the collection of applicant data, evaluation of functional criteria, and assessment of major life activities.

• The form is used by healthcare professionals and social workers to determine eligibility for individuals with related conditions.
• The form evaluates an individual's ability to perform various tasks and assesses their major life activities.
• The form helps identify areas of difficulty and provides targeted support and accommodations.