Social Security

Form H1012, titled Immunization Record, is a documentation form used to track a child’s immunization history for eligibility, compliance, or review purposes. It records whether a child has received the minimum required immunization visits appropriate for their age, or whether a valid reason exists for not meeting those requirements.

This form is commonly used in benefit eligibility reviews, child-related case management, and compliance checks where proof of immunization or a recognized exemption must be documented in a consistent and verifiable way.

The Electronic Correspondence Confirmation Letter (Form H1013) is a crucial document that confirms electronic correspondence between the Texas Health and Human Services Commission (HHSC) and an individual. This form helps ensure that important notices and updates are delivered efficiently and effectively to those who rely on them.

This page explains Form H-1010R — “Your Texas Benefits: Renewal Form” — a renewal and update form used by the Texas Health and Human Services Commission (HHSC). The form helps current benefit recipients confirm or update household, income, and contact information so HHSC can keep benefits active or decide continued eligibility. The guidance below interprets the form’s sections, highlights common pitfalls, and gives practical tips for completing and returning the form on time.

The TX HHS Form H1010-MR, MAGI Renewal Addendum, is a crucial document for individuals applying for or renewing Medicaid or CHIP benefits. This form helps solve the problem of providing required information to support an application or renewal request.

Form H1009 is an official notice issued by the Texas Health and Human Services Commission (HHSC) to inform applicants and recipients about their eligibility for Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) benefits. This document explains whether benefits are approved, the amount and period of assistance, and what actions the household must take to keep receiving benefits.

The TX HHS Form H1008-A, Warrant Inquiry and EBT Benefit Conversion and Affidavit for Non-receipt of Warrant, is a crucial document that helps resolve issues related to the receipt or non-receipt of benefits issued by warrant. This form is typically used in situations where clients have not received their warrants or need assistance with converting their Electronic Benefits Transfer (EBT) benefits to a warrant.

Form H1004 is a notice sent by the Texas Health and Human Services Commission (HHSC) when someone submits a benefits application on behalf of another person and claims to be their authorized representative. The letter explains that HHSC cannot process the application until proof of this authorization is provided. In many cases, Form H1004 is the applicant’s first indication that additional documentation is required to validate their role.

The TX HHS Form H1003, Appointment of an Authorized Representative, allows individuals to designate another person to act on their behalf in various situations. This form is typically used when an individual needs assistance with the application process for Medicaid or Children's Health Insurance Program (CHIP) benefits.

The TX HHS Form H1000-A, Notice of Application, helps individuals or organizations notify the relevant authorities about their intention to apply for a specific program or service. This form is typically used in situations where prior approval or notification is required before applying for assistance.

The TX H0926 Form, "Sharing Facts About Me and My Case with a Community Partner", is a crucial document for individuals seeking assistance from the Texas Health and Human Services Commission (HHSC) in applying for benefits. This form enables applicants to authorize community partners to share their personal information and case details, facilitating the application process.