TX HHS Form 5873. Waiver and Community-based Programs and Services - Medicaid and CHIP Services Contract Application Packet Checklist
Form 5873 is an official checklist used in Texas during the application process for provisional contracts under Waiver and Community-based Programs and Services for Medicaid and CHIP.
TX HHS Form 8615. On-site and Off-site Individualized Skills and Socialization Service Delivery Log
Form 8615 is an official service documentation form used in Texas for Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs. It serves as a detailed delivery log for Individualized Skills and Socialization services provided both on-site and off-site.
TX HHS Form H2060-A. Addendum to Form H2060
Form H2060-A is an official Texas Health and Human Services Commission (HHSC) document used as an addendum to Form H2060. It is designed to identify and authorize additional Personal Assistance Services (PAS) hours that were not fully captured in the original needs assessment.
Form MCSA-5871. Vision Evaluation Report
The MCSA-5871 Vision Evaluation Report is a mandatory form used by the Federal Motor Carrier Safety Administration (FMCSA) to assess whether individuals meet the vision standards required to operate commercial motor vehicles in interstate commerce.
Pennsylvania Department of Transportation Forms
Pennsylvania has a wide range of forms related to driver's licenses, identification cards, and vehicle registration.
PA DOT Form DL-180TD. Parent or Guardian Consent Form
The DL-180TD is a Parent or Guardian Consent Form required by the Pennsylvania Department of Transportation (PennDOT) for minor applicants seeking a driver's license.
PA DOT Form DL-180C. Parent Or Guardian Certification Form
The Pennsylvania Parent or Guardian Certification Form (DL-180C) is a critical document for minors applying for a learner's permit.
Form DL 62. Report of Vision Examination
Form DL 62 is a confidential medical document used by the California Department of Motor Vehicles (DMV) to evaluate whether a driver’s vision meets the minimum standards required for safe vehicle operation.
Form LIC 9182. Criminal Background Clearance Transfer Request - California
The Criminal Background Clearance Transfer Request (Form LIC 9182) is used when an individual who already holds an active criminal record clearance in California needs to transfer that clearance from one licensed facility, organization, or home to another.
TX HHS Form 2993. General Residential Operations Medication Log
The GRO Medication Log (Form 2993) is a mandatory record used in Texas residential childcare operations to track every prescription, nonprescription medication, and supplement administered to a child.