Texas Health and Human Services

TX HHS Form 4121. Home and Community-based Services/Texas Home Living Community First Choice Personal Assistance Services/Habilitation

TX HHS Form 4121. Home and Community-based Services/Texas Home Living Community First Choice Personal Assistance Services/Habilitation

The TX HHS Form 4121, "Home and Community-based Services/Texas Home Living Community First Choice Personal Assistance Services/Habilitation", is a crucial tool for individuals receiving personal assistance services. This form helps to document the provision of these services, ensuring that all necessary information is recorded and accounted for.

TX HHS Form 4119. Residential Support Services (RSS) and Supervised Living (SL) Service Delivery Log

TX HHS Form 4119. Residential  Support Services (RSS) and Supervised Living (SL) Service Delivery Log

The TX HHS Form 4119, Residential Support Services (RSS) and Supervised Living (SL) Service Delivery Log, is a practical tool for documenting the delivery of support services to individuals receiving RSS or SL services. This form helps solve the problem of tracking and recording the provision of these essential services, ensuring that individuals receive the necessary care and support.

TX HHS Form 4117. Supported Employment/Employment Assistance Service Delivery Log

TX HHS Form 4117. Supported Employment/Employment Assistance Service Delivery Log

The Supported Employment/Employment Assistance Service Delivery Log (Form 4117) is a practical tool designed to track the delivery of employment services for individuals with disabilities. This form helps solve the problem of monitoring and recording the progress of employment assistance programs, ensuring that participants receive the necessary support and guidance to achieve their goals.

TX HHS Form 4116-MHM-AA. Minor Home Modification and Adaptive Aids Summary Sheet

TX HHS Form 4116-MHM-AA. Minor Home Modification and Adaptive Aids Summary Sheet

The TX HHS Form 4116-MHM-AA, Minor Home Modification and Adaptive Aids Summary Sheet, is a crucial tool for healthcare professionals and caregivers to document minor home modifications and adaptive aids provided to individuals with disabilities. This form helps solve the problem of ensuring that necessary adjustments are made to an individual's living environment to promote independence and safety.

TX HHS Form 4116-MHM-AA. Minor Home Modification and Adaptive Aids Summary Sheet

TX HHS Form 4116-MHM-AA. Minor Home Modification and Adaptive Aids Summary Sheet

The TX HHS Form 4116-MHM-AA, Minor Home Modification and Adaptive Aids Summary Sheet, is a crucial document for individuals seeking home modifications or adaptive aids to enhance their daily living experience. This form helps solve the problem of identifying necessary modifications or aids required to support independent living, particularly for those with disabilities or chronic illnesses.

TX HHS Form 4116-DME. ICF/IID Durable Medical Equipment Summary Sheet

TX HHS Form 4116-DME. ICF/IID Durable Medical Equipment Summary Sheet

The TX HHS Form 4116-DME, ICF/IID Durable Medical Equipment Summary Sheet, is a practical tool designed to help track and manage durable medical equipment (DME) for individuals with intellectual or developmental disabilities. This form is typically used by healthcare providers, caregivers, or case managers to document the DME needs of clients receiving services under the Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) program.