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.

ES = Spanish version available.

Title
Form 2125, HCS, TxHmL and CFC – Implementation Plan
Form 6520, Deaf Blind with Multiple Disabilities (DBMD) Record of Completion for the DBMD Program Service Provider Training
Form 6518, Deaf Blind with Multiple Disabilities (DBMD) Record of Completion for Person-Specific Training, Instructions
Form 3262, Licensed Chemical Dependency Counselor Intern Supervised Work Experience Documentation
Form H0050, Parent Profile Questionnaire ES
Form 1584, Consumer Participation Choice ES
Form 2060-B, Needs Assessment Addendum ES
Form 1043, Post-Move Monitoring
Form 1042, Pre-Move Site Review
Form 1581, Consumer Directed Services (CDS) Option Overview ES
Form 3948, DHHS & STAP Request for Replacement Equipment Because of a State or Federally Declared Disaster
Form H1210, Subrogation for Trusts, Annuities and Court Settlements
Form 3691-A, Service Area Designation HCS, TxHmL, CDS and TAS
Form H2060-B, Needs Assessment Addendum ES
Form 8654, State Supported Living Center (SSLC) Admission Application