TX HHS Form H1278. Request for Patient Trust Fund Information

The TX HHS Form H1278, Request for Patient Trust Fund Information, is a crucial document that helps individuals track their patient trust fund balances and interest earnings. This form is typically used by patients who have had a patient trust fund within the last six months and need to provide information about their account.

This form requires the individual to provide specific information, including the balance of their trust fund as of 12:01 a.m. on the first day of each month listed, as well as the amount of interest earned during that period. The form must be verified by the individual's signature and date, and returned in the provided envelope.

• This form is used to track patient trust fund balances and interest earnings over a six-month period.
• It is typically filled out by patients who have had a patient trust fund within the last six months.