TX HHS Form H1746-A. MEPD Referral Cover Sheet

The TX HHS Form H1746-A, MEPD Referral Cover Sheet, is a crucial document for healthcare professionals and social workers who need to refer individuals to Medicaid programs for the Elderly and People with Disabilities (MEPD). This form helps solve the problem of facilitating referrals and ensuring that necessary information is provided to process applications.

The form requires specific information from applicants, including their case number, zip code, county, individual social security number, and date of birth. It also asks for details about the referral type, such as whether it's for an applicant and spouse, or a significant change in circumstances. The form emphasizes the importance of completing all required fields and provides instructions on how to submit the document.

The MEPD Referral Cover Sheet is typically used by healthcare professionals, social workers, and other authorized individuals who need to refer clients to Medicaid programs for the Elderly and People with Disabilities. Key features of the form include required information, conditions, and follow-up actions. By using this form, users can ensure that necessary information is provided to process applications efficiently and effectively.

• The form requires specific information from applicants, including case number, zip code, county, individual social security number, and date of birth.
• The form asks for details about the referral type, such as whether it's for an applicant and spouse, or a significant change in circumstances.
• The form emphasizes the importance of completing all required fields and provides instructions on how to submit the document.