TX HHS Form 3074. Physician Certification of Terminal Illness
Form 3074, titled Physician Certification of Terminal Illness, is an official Texas Health and Human Services Commission (HHSC) document used within the Texas Medicaid Hospice Program.
TX HHS Form H1146-M. Medicaid Report (Manual)
Form H1146-M is an official Medicaid reporting document used by the Texas Health and Human Services Commission (HHSC) for families receiving Transitional Medicaid.
TX HHS Form 8619. State Long-Term Care Ombudsman Program Case Record
Form 8619 is a confidential case record used within the State Long-Term Care Ombudsman Program. It serves as the official internal document for recording, tracking, and resolving complaints related to long-term care facilities, including nursing facilities and assisted living facilities.
TX HHS Form 3015. Application for a Child Care Administrator License or a Child-Placing Agency Administrator License
Form 3015 is the official Texas application used to request a Child Care Administrator License or a Child-Placing Agency Administrator License. It is filed with Texas Health and Human Services (HHS) and reviewed by Child Care Regulation (CCR).
TX HHS Form 8708. Criminal History Disclosure
Form 8708, Criminal History Disclosure, is an official Texas Health and Human Services (HHS) document used to collect detailed criminal background information from individuals applying for, working in, or volunteering with certain state-regulated programs and facilities.
OCFS-6008. Caregiver, Employee, Volunteer Attendance
Form OCFS-6008 – Caregiver, Employee, Volunteer Attendance is an official record-keeping document issued by the New York State Office of Children and Family Services (OCFS).
TX HHS Form H1140. Verification of Benefits
Form H1140, titled Verification of Benefits, is an official document used by the Texas Health and Human Services Commission (HHSC) to confirm information about public assistance benefits received by an individual or household.
TX HHS Form H2067-MC. Managed Care Programs Communication
Form H2067-MC, titled “Managed Care Programs Communication,” is an official Texas Health and Human Services (HHS) document used to exchange critical information between a Managed Care Organization (MCO) and the Program Support Unit (PSU).
TX HHS Form 2911. CCR Governing Body or Director Designation
Form 2911 is an official document used in Texas Child Care Regulation (CCR) to formally designate an individual who is authorized to speak and act on behalf of a child care operation, as well as to designate a director or interim director.
TX HHS Form H1808. Agreement to Follow SNAP Work Rules
Form H1808, titled “Agreement to Follow SNAP Work Rules”, is an official document used by the Texas Health and Human Services Commission (HHSC).