Texas Health and Human Services

The TX HHS Form 3612 Transfer Process Checklist is a crucial document that facilitates the transfer of services for individuals in Texas Health and Human Services (HHS) programs. This form helps solve the problem of ensuring a smooth transition between service providers, allowing individuals to choose their preferred provider or Financial Management Services Agency (FMSA). The form is typically used when an individual or legally authorized representative (LAR) desires a transfer, and the service coordinator (SC) must begin the process within three days.

The TX HHS Form 3613, Provider Investigation Report with Fax Cover Sheet, is a crucial tool for home health, hospice, and personal assistance services providers in Texas. This form helps resolve complaints and incidents related to these services by providing a standardized framework for reporting and investigating issues.

The TX HHS Form 3615, "Request to Continue Suspension of Waiver Program Services," is a crucial document for individuals who require waiver program services, such as Texas Home Living (TxHmL) or Home and Community-based Services (HCS). This form helps solve the problem of requesting continued suspension of these services when an individual's circumstances change.

The TX HHS Form 3616 is a request for termination of services provided by Home and Community-based Services (HCS) or Texas Home Living (TxHmL) Waiver Provider. This form helps solve the problem of ending enrollment in these waiver programs when an individual's circumstances change, making it necessary to terminate their participation.

The TX HHS Form 3617, Request for Transfer of Waiver Program Services, is a crucial document that helps individuals with intellectual and developmental disabilities (I/DD) transfer their waiver program services to a new provider. This form is typically used in situations where an individual needs to change their service provider due to various reasons such as relocation or dissatisfaction with the current provider.

The Resident Transaction Notice (TX HHS Form 3618) is a crucial document that helps track and record resident transactions in various healthcare settings. This form is typically filled out by administrators or authorized personnel in hospitals, nursing facilities, hospices, and other long-term care institutions to provide essential information about patient admissions, discharges, and transfers.

The TX HHS Form 3619, Medicare/Skilled Nursing Facility Patient Transaction Notice, is a crucial document that helps resolve issues related to patient transactions in skilled nursing facilities. This form is typically used in situations where patients are transitioning from hospitals or other institutions to skilled nursing facilities, and it provides a record of the transaction details.

The TX HHS Form 3621, CLASS or CFC Individual Plan of Care, is a crucial document that helps individuals with disabilities develop a personalized plan for receiving community-based services. This form is typically used in situations where an individual requires ongoing support to maintain their independence and quality of life.

The TX HHS Form 3621-T, CLASS and CFC IPC Service Delivery Transfer Worksheet, is a practical tool designed to facilitate the transfer of services between Community Living Assistance and Support Services (CLASS) or First Choices (CFC) providers. This form helps solve the problem of ensuring seamless continuity of care for individuals receiving services by streamlining the process of transferring service delivery.

The TX HHS Form 3623, Approval of Application for CLASS, is a crucial document that facilitates the enrollment process in the Community Living Assistance and Support Services (CLASS) Program. This form helps solve the problem of ensuring eligible individuals can access necessary services to maintain their independence and quality of life.