TX HHS Form 2948. Plan of Operation for Licensed Center and Home Operations
Form 2948 is a core document required for anyone seeking to operate a Licensed Child Care Center or a Licensed Child Care Home in Texas.
TX HHS Form H1010-R. Your Texas Works Benefits Renewal Form
This page explains Form H-1010R — “Your Texas Benefits: Renewal Form” — a renewal and update form used by the Texas Health and Human Services Commission (HHSC).
TX HHS Form H1836-B. Medical Release or Physician's Statement
Form H1836-B, Medical Release or Physician’s Statement, is a Texas Health and Human Services Commission (HHSC) document used to verify that a patient has a disabling illness or injury requiring full-time assistance from a caregiver.
TX HHS Form H1861. Federal Tax Information Record Keeping and Destruction Log
The “Federal Tax Information Record Keeping and Destruction Log” (Form H1861, March 2021-E) is a compliance document used by agencies and staff who handle Federal Tax Information (FTI).
TX HHS Form 8585. RN Delegation Worksheet for 22 TAC Chapter 225
Form 8585 is a Delegation Worksheet used by Registered Nurses (RNs) in Texas when evaluating whether specific health-related tasks for individuals with stable and predictable conditions can be delegated to unlicensed personnel under 22 TAC Chapter 225.
TX HHS Form 8002. Transportation Log
Form 8002 is a transportation log used within the Home and Community-Based Services – Adult Mental Health (HCBS-AMH) Program.
TX HHS Form 5026. HIPP Summary of Insurance Expenditure Request
This document, officially known as Form 5026: Summary of Insurance Expenditure Request, is used within the Texas Health Insurance Premium Payment (HIPP) program.
TX HHS Form H3035. Medical Information Release and Disability Determination
This form is used when a person applies for disability-related assistance through the Texas Health and Human Services Commission (HHSC). It authorizes HHSC to request medical records from healthcare providers in order to evaluate disability status under federal Social Security guidelines.
TX HHS Form H1072. One Time Temporary Assistance for Needy Families (OTTANF) Acknowledgement
This document serves as the applicant’s official acknowledgement of the rules attached to receiving a one-time $1,000 payment under the One-Time Temporary Assistance for Needy Families (OTTANF) program in Texas.
TX HHS Form H1050. Check Verification
Form H1050, also known as the Check Verification form, is used to confirm details about checks being cashed on behalf of a client.