Forms

HHS forms are used every day to perform tasks such as applying for benefits, contracting to provide goods or services, reporting incidents, declaring end of life wishes, and conducting other business.

Title
Form 5402, Office of Communications – Media Release ES
Form 1681, Home and Community-based Services (HCS) ES
Form 1729, Applicant Verification for Employees ES
Form 1733, Employer and Employee Acknowledgement of Exemption from Nursing Licensure for Certain Services Delivered through Consumer Directed Services ES
Form 5535, Reciprocity Licensure Questionnaire
Form 5518-NFA, Provisional Licensure Questionnaire
Form 5506-NAR, Texas Nurse Aide Registry Employment Verification
Form 7255, Medication Authorization ES
Form 5873, Waiver and Community-based Programs and Services - Medicaid and CHIP Services Contract Application Packet Checklist
Form 3018, Administrator Licensing – Change in Contact Information
Form 3016, Administrator Licensing Reference for an Applicant
Form 3014, Administrator License – Renewal or Status Change
Form 7271, Personnel Records Evaluation LCCH/RCCH
Form 7263, Emergency Practices
Form 7260, Children's Records Evaluation of Child Care Centers