The TX HHS Form 3273, General and Special Hospital License Designation Change Application, is a crucial document for hospitals in Texas seeking to modify their license designation. This form helps solve the problem of updating hospital services and designations to ensure compliance with state regulations.
The TX HHS Form 3301, Residential Treatment Center Project Family Agreement, is a crucial document that helps solve the problem of initiating a child's enrollment in a Residential Treatment Center (RTC) project. This form is typically used by the legally authorized representative (LAR) to sign and acknowledge their responsibility for their child while enrolled in the RTC project.
The TX HHS Form 3302, Standard Application for Residential Treatment Services, serves as an application for admission to the Health and Human Services Commission's Waco Center for Youth (WCY) or Residential Treatment Center (RTC) Project. This form is completed by the referring agency and provides essential information about a child seeking residential treatment services.
The TX HHS Form 3454, Compliance and Quality Case Review, is a crucial tool for ensuring the effective delivery of Comprehensive Rehabilitation Services (CRS). This form helps healthcare providers assess the eligibility of consumers for CRS and identify areas for improvement in their application and diagnostic interview processes.
The LCDC License Application (Form 3266) is the final step for registered counselor interns in Texas who are ready to advance to full licensure. This form confirms that an applicant has completed all training, supervised work experience, educational requirements, and examinations required by the Texas Health and Human Services Commission (HHSC) under 26 TAC Chapter 562 and Texas Occupations Code Chapter 504.
Form 3262 is the official document used in Texas to verify and report the supervised work experience hours completed by a Licensed Chemical Dependency Counselor (LCDC) Intern. It is submitted directly to the Texas Health and Human Services Commission (HHSC) by a Clinical Training Institution (CTI) coordinator or a Certified Clinical Supervisor (CCS). This form plays a crucial role in transitioning an intern toward full LCDC licensure, making accuracy and regulatory compliance essential.
The TX HHS Form 3082, Notice of Ineligibility, is a crucial document for individuals who have applied for County Indigent Health Care Program (CIHCP) benefits but have been denied. This form serves as formal notification to the applicant, outlining the reasons for denial and providing information on the appeal process.
The TX HHS Form 3083, Optional Health Care Services Notification, is a crucial document that helps counties in Texas notify the state of their optional health care services. This form is typically used by county officials to indicate which health care services they choose to provide or discontinue for indigent clients.
The TX HHS Form 3084, Employment Verification, helps determine the eligibility of a household applying for health care assistance from the County Indigent Health Care Program (CIHCP). This form is used to verify all earnings of an individual who is, was, or will be employed by another person. Typically, this form is completed by employers who need to provide employment information to support their employee's application for healthcare benefits.
The TX HHS Form 3085, Statement of Self-Employment Income, is a crucial document for individuals who earn income through self-employment. This form helps solve the problem of accurately reporting self-employment income to the County Indigent Health Care Program (CIHCP). Typically, this form is used by self-employed individuals who need to provide proof of their income to the CIHCP.
