The TX HHS Form 1061, Class D Pharmacy License Exemption Request, is a crucial document for healthcare providers seeking to exempt themselves from obtaining a Class D pharmacy license. This form helps solve the problem of streamlining pharmaceutical services for eligible individuals by allowing clinics to partner with referral pharmacies and provide medications without an additional clinic visit.
The TX HHS Form 1062, Zika Supplies, is a crucial document that helps track and manage the distribution of essential supplies related to Zika virus outbreaks. This form is typically filled out by healthcare providers, government agencies, or non-profit organizations involved in responding to Zika-related emergencies.
The TX HHS Form 1063, Individual Profile - Nursing Facility, is a crucial document that helps solve the problem of collecting essential information about an individual's needs and circumstances in a nursing facility setting. This form is typically used by Local Intellectual and Developmental Disabilities Authorities (LIDDA) to gather data on individuals with intellectual or developmental disabilities who reside in nursing facilities.
The TX HHS Form 1064, Habilitative Assessment, is a crucial tool for identifying an individual's habilitative needs that can be supported or enhanced with Preadmission Screening and Resident Review (PASRR) habilitative specialized services. This assessment helps solve the problem of determining an individual's unique requirements for habilitation services, which is essential for developing effective support plans.
The TX HHS Form 1065, Breast and Cervical Cancer Services (BCCS) Program or Family Planning Program (FPP) Eligibility Application, is a crucial document for individuals seeking to access essential healthcare services. This form helps solve the problem of determining eligibility for these programs by gathering necessary information about the applicant and their household.
The TX HHS Form 1066, Transfer Request for PASRR DME and CMWC, is a crucial document that facilitates the transfer of durable medical equipment (DME) or custom manual wheelchairs (CMWC) from one nursing facility to another. This form is specifically designed for nursing facility residents who have been identified as Preadmission Screening and Resident Review (PASRR) positive.
The TX HHS Form 1067, Offer of Home and Community-based Services (HCS) Program, helps individuals with intellectual or developmental disabilities access long-term care services. This form is used in situations where funding is available to offer the HCS program, which provides life-long support for changing needs.
The Texas Health and Human Services (HHS) Form 1068, Withdrawal of Offer for Home and Community-based Services (HCS) Program, is a notification form used to inform individuals that their offer to enroll in the HCS program has been withdrawn. This situation typically arises when an individual fails to respond within a specified timeframe or does not complete necessary activities to finalize enrollment.
The TX HHS Form 1069, Withdrawal of Offer of Texas Home Living Program, is a crucial document that helps individuals withdraw their offer to enroll in the Texas Home Living (TxHmL) program. This form is typically used when an individual's offer to participate in the TxHmL program has been withdrawn due to non-response or incomplete enrollment process.
The TX HHS Form 1070, Offer of Texas Home Living Program, helps individuals with intellectual or developmental disabilities access life-long services that meet their changing needs. This form is typically used by the Local Intellectual and Developmental Disability Authority (LIDDA) to offer waiver program services to eligible individuals.
