TX HHS Form 3051. Statement of Self-Employment Income
Form 3051 is used by individuals who are self-employed and applying for health care assistance under the Primary Health Care Services Program, the Title V Fee-for-Service Program, or the Epilepsy Program.
TX HHS Form 3050. DAHS Health Assessment or Individual Service Plan
Form 3050 is a core medical and functional assessment used in Texas Day Activity and Health Services (DAHS) programs. The form helps a DAHS nurse document a participant’s physical condition, cognitive abilities, daily care needs, and the specific supports that the facility will provide.
TX HHS Form 3049. Employment Verification
The TX HHS Form 3049, Employment Verification, helps determine the eligibility of a household applying for health care assistance from various programs. This form is typically completed by an employer to verify the employment status of an individual who is receiving or has received benefits.
TX HHS Form 3048. Notice of Eligibility
The TX HHS Form 3048, Notice of Eligibility, is a crucial document that helps individuals or households receive approved services for the Epilepsy program.
TX HHS Form 3047. Notice of Ineligibility
The TX HHS Form 3047, Notice of Ineligibility, is a crucial document for individuals who have applied for various health programs in Texas. This form serves as a notification to applicants that their application has been denied due to not meeting the program eligibility requirements.
TX HHS Form 3045. Office of Primary and Specialty Health Presumptive Eligibility Notice
The TX HHS Form 3045, Presumptive Eligibility Notice, is a crucial document that helps address immediate medical or dental needs of clients who are unable to complete the eligibility determination process at the time of application.
TX HHS Form 3044. Home and Community Based Services Adult Mental Health (HCBS-AMH) Settings Checklist
The TX HHS Form 3044, Home and Community Based Services Adult Mental Health (HCBS-AMH) Settings Checklist, is a practical tool used to ensure compliance with adult mental health settings in Texas.
TX HHS Form 3043. MH Child and Adolescent Needs and Strengths (CANS) - Age 6-17
The Texas Health and Human Services (HHS) Form 3043, MH Child and Adolescent Needs and Strengths (CANS) - Age 6-17, is a comprehensive assessment tool designed to help professionals identify the needs and strengths of children and adolescents aged 6-17.
TX HHS Form 3042. MH Child and Adolescent Needs and Strengths (CANS) Ages 3 through 5
The TX HHS Form 3042, MH Child and Adolescent Needs and Strengths (CANS) Ages 3 through 5, is a practical tool designed to assess the needs and strengths of children aged 3-5.
TX HHS Form 3041. MH Adult Uniform Assessment for Texas Resilience and Recovery
The TX HHS Form 3041, MH Adult Uniform Assessment for Texas Resilience and Recovery, is a crucial tool for healthcare professionals to assess the needs and strengths of adult patients.