TX HHS Form H1836-B. Medical Release or Physician's Statement

The TX HHS Form H1836-B, Medical Release or Physician's Statement, is a crucial document that helps solve the problem of verifying a patient's disabling illness or injury. This form is typically used in situations where an individual is receiving benefits from Texas Health and Human Services (HHS) and requires medical validation to support their claim.

The form requires completion by both the staff member and the physician. The staff member provides basic information about the patient, including name, date of birth, social security number, and office address. The physician completes Section 2, providing a diagnosis and indicating the extent to which the caregiver can work or participate in activities to prepare for work.

Key features of this form include the required information provided by both the staff member and the physician, as well as the conditions and responsibilities outlined in Part A. Specifically:

• The caregiver's ability to work or participate in activities is marked as full-time, part-time, or unable to do so.
• A diagnosis is provided for the patient's disabling illness or injury.