TX HHS Form H3035. Medical Information Release and Disability Determination

The Texas Medical Information Release and Disability Determination Form H3035 is a crucial document for individuals seeking disability benefits from the Texas Health and Human Services (HHS). This form helps applicants provide necessary medical information to determine their eligibility for services. Typically filled out by the applicant or their authorized representative, this form ensures that healthcare providers and facilities release relevant medical records without charging a fee.

The form consists of three sections: PART I provides general information about the applicant, while SECTION I is completed by HHSC staff to gather details about the applicant's medical needs. SECTION II requires the applicant or their authorized representative to authorize the release of medical records to HHSC, which may include contacting doctors, medical facilities, and other healthcare providers. The form also includes a notice to applicants regarding the protection of personal health information.

Key features of this form include the required information, such as applicant name, date of birth, social security number, and application/case number. Additionally, the form highlights the importance of verifying medical needs to determine eligibility for services. By filling out this form, applicants can ensure a smoother process for determining their disability benefits. Some key points to note are:

• The applicant or authorized representative must sign the authorization form to release medical records.
• HHSC may contact healthcare providers and facilities to request copies of health information.
• The applicant's signature is required to determine eligibility for services.