TX HHS Form 3052. Practitioner's Statement of Medical Need
Form 3052, titled Practitioner’s Statement of Medical Need, is a required medical certification used in Texas Medicaid Personal Attendant Services programs, specifically Primary Home Care (PHC) and Community Attendant Services (CAS).
IRS Form W-2. Wage and Tax Statement
IRS Form W-2, also known as the Wage and Tax Statement, is a critical form used in the United States tax system. It is used by employers to report annual wages and taxes withheld from employees' paychecks to the IRS and the Social Security Administration (SSA).
IRS Form W-3. Transmittal of Wage and Tax Statements
Form W-3, Transmittal of Wage and Tax Statements, is a tax form used by employers to transmit employee wage and tax information to the Social Security Administration (SSA). This form is a summary of all the W-2 forms issued to employees and is required to be filed annually.
TX HHS Form H1817. SNAP Information Transmittal
Form H1817, known as the SNAP Information Transmittal, is a communication form used in Texas to exchange case-related information between Employment Contractors and Health and Human Services Commission (HHSC) staff.
TX HHS Form 7270. Children's Records Evaluation of a Licensed Child Care Home or Registered Child Care Home
Form 7270 is an official inspection and compliance tool used in Texas to document the evaluation of children’s records at a Licensed Child Care Home (LCCH) or a Registered Child Care Home (RCCH).
TX HHS Form 2937. Child Care Regulation Waiver/Variance Request
Form 2937 is an official request used by Texas child care providers to apply for a waiver or variance from specific Child Care Regulation (CCR) minimum standards.
TX HHS Form 5102. Participant Information
Form 5102 is used to document participant attendance and basic demographic information for youth enrolled in a Youth Prevention Program.
TX HHS Form H1204. Long Term Care Options
Form H1204 is an informational document used by the Texas Health and Human Services Commission (HHSC) to help individuals, families, and caregivers understand available long-term care services and supports across Texas.
TX HHS Form 6104. Freestanding Emergency Medical Care Facility Incident Report
Form 6104 is the official incident reporting document used by freestanding emergency medical care facilities in Texas to report serious, reportable events to state regulators.
TX HHS Form 8618. State Long-Term Care Ombudsman Program Initial Certification Training Log
Form 8618 is an official training log used by the State Long-Term Care Ombudsman Program to document completion of initial certification requirements for ombudsman trainees.