Texas Health and Human Services

The TX HHS Form 5512-NATCEP is a request form for individuals who have completed an RN or LVN school in the state of Texas to take the Competency Evaluation Program (CEP). This program helps solve the problem of ensuring that nurse aide students are competent and ready to practice as certified nurse aides. The form is typically used by recent graduates of RN or LVN schools who wish to demonstrate their competence through the CEP.

The TX HHS Form 5511-NATCEP is a request form for individuals who have completed military training equivalent to civilian nurse aide training and wish to take the Competency Evaluation Program (CEP) in Texas. This form helps solve the problem of obtaining approval to take the CEP, which is required for nurse aides seeking certification.

The TX HHS Form 5510-NATCEP is a request form for individuals who have completed nurse aide training out of state to take the Competency Evaluation Program (CEP) in Texas. This form helps solve the problem of allowing trained nurse aides from other states to demonstrate their competence and gain certification in Texas, facilitating their employment and career advancement.

The TX HHS Form 5507-NAR, Request for Waiver of Nurse Aide Training and Competency Evaluation, is a crucial document that helps individuals who completed a nurse aide training program prior to July 1, 1989, request a waiver from the Texas Nurse Aide Registry. This form is typically used by those who have already completed a training program and are seeking to be placed on the registry.

The TX HHS Form 5498-NATCEP, Nurse Aide Daily Sign-in Sheet, is a crucial tool for tracking student attendance and completion of training hours in the Texas Health and Human Services (HHS) Nurse Aide Training and Competency Evaluation Program (NATCEP). This form helps ensure that students meet the program's requirements and instructors can accurately monitor progress.

Form 5102 is used to document participant attendance and basic demographic information for youth enrolled in a Youth Prevention Program. The form captures session participation, age, race, ethnicity, and gender data to support program accountability, reporting requirements, and evaluation of prevention services delivered in school or community settings.

Form 5401 is an official authorization used by Texas Health and Human Services (HHS) to obtain consent for photographing, audio recording, or video recording a resident of a State Supported Living Center (SSLC) or a patient of a State Hospital (SH). This form protects individual rights while allowing HHS to use media materials for specific, limited purposes related to public programs.

This document provides a structured support plan for children who are blind or visually impaired and their families. Form 5150 is used by the Division for Blind Services (DBS) to outline goals, services, and responsibilities that help a child build independence, develop core life skills, and explore early vocational interests. Although the form appears administrative, it serves as a roadmap that coordinates multiple agencies and specialists working together to support a child’s development.

Form 4807-D is used by Texas Health and Human Services (HHS) staff to document how a local office handled a fair hearing decision. Although the form looks administrative, it plays an important legal role: it confirms when a hearing decision was received, what action the agency took, whether benefits were restored, and whether delays occurred. For anyone involved in appeals within public assistance programs, this form is the official record that shows the agency followed the Hearing Officer’s ruling.

This document, officially known as Form 5026: Summary of Insurance Expenditure Request, is used within the Texas Health Insurance Premium Payment (HIPP) program. The form allows families to report out-of-pocket medical and prescription expenses for Medicaid-eligible household members who are covered under an employer-sponsored insurance plan. Although the form is short, it plays an important administrative role: it ensures that families receive the correct reimbursement or premium assistance under the HIPP program.