TX HHS Form 0006. Service Provider Printed Forms Order
Form 0006, titled “Service Provider Printed Forms Order,” is designed to help service providers in Texas request printed forms free of charge. It ensures that organizations can obtain the necessary documents for assisting clients with benefits and services efficiently.
TX HHS Form 5497-NATCEP. Texas Nurse Aide Performance Record
The Texas Nurse Aide Performance Record (Form 5497-NATCEP) is a key document used within the Nurse Aide Training and Competency Evaluation Program (NATCEP).
TX HHS Form H1019. Report of Change
Form H1019, issued in October 2024, is the official Texas Health and Human Services Commission (HHSC) document for reporting changes that may affect your benefits.
TX HHS Form H1836-A. Medical Release and Physician's Statement
Form H1836-A, titled Medical Release/Physician's Statement, is used by the Health and Human Services Commission (HHSC) in Texas to verify medical conditions that may prevent individuals from participating in employment services programs.
TX HHS Form H3038. Emergency Medical Services Certification
Form H3038, issued by the Texas Health and Human Services Commission (HHSC), is used to certify that a patient received emergency medical services.
TX HHS Form H1837. Physician's Statement of Permanent Disability
The Physician’s Statement of Permanent Disability (Form H1837) is a document used by the Texas Health and Human Services Commission (HHSC) to verify whether an applicant for the Supplemental Nutrition Assistance Program (SNAP) meets the state’s definition of a permanent disability.
TX HHS Form 0066. Request for Authorized Electronic Monitoring
The “Request for Authorized Electronic Monitoring” form is a short but legally significant document used in Texas long-term care facilities.
TX HHS Form 8511. Understanding Program Eligibility and Services
Form 8511 is used in Texas to help individuals and families understand the eligibility rules and core service principles for the Home and Community-based Services (HCS) Program and the Texas Home Living (TxHmL) Program.
TX HHS Form H3038-P. CHIP Perinatal - Emergency Medical Services Certification
Form H3038-P is used in Texas to document that a non-citizen patient received treatment for a true medical emergency.
TX HHS Form H1053-IME. Provider Notice of Incurred Medical Expense Decision
The Provider Notice of Incurred Medical Expense Decision (Form H1053-IME) is a communication tool used by the Texas Health and Human Services Commission (HHSC). It informs long-term care providers about HHSC’s decision to approve or deny an individual's Incurred Medical Expense (IME).