TX HHS Form H4870. Client Complaint of Discrimination

The TX HHS Form H4870, Client Complaint of Discrimination, is a crucial tool for individuals who have experienced discrimination in Texas. This form helps solve the problem of reporting incidents of discrimination to the appropriate authorities, ensuring that those responsible are held accountable. Typically, this form is used by individuals who believe they have been discriminated against due to their race, color, religion, age, sex, national origin, or disability.

This form requires the client to provide essential information, including their name, area code and phone number, and a detailed description of the incident. The client must also specify the charge of discrimination and the reason for filing the complaint. Additionally, if someone other than the client is completing this form, they must provide additional information about themselves.

The Texas Health and Human Services Commission (HHSC) Regional Staff will review the completed form and take necessary follow-up actions. The HHSC also provides guidance on an individual's right to request and receive information about their personal data, as well as the process for correcting incorrect information. Key points to note include:

• The form is used to report incidents of discrimination in Texas.
• The client must provide detailed information about the incident and the reason for filing the complaint.
• The HHSC Regional Staff will review the completed form and take necessary follow-up actions.