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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 3617, Request for Transfer of Waiver Program Services
Form 3616, Request for Termination of Services Provided by HCS/TxHmL Waiver Provider
Form 3615, Request to Continue Suspension of Waiver Program Services
Form 3611, Involuntary Termination of Consumer Directed Services IPC Cover Sheet
Form 3610, Informal Review Request
Form 1744, TxHmL/CFC Entrance Conference
Form 1742, Service Backup Plan for HCS, TxHmL and CFC Services
Form 1592, RN Delegation Checklist
Form 1572, Nursing Tasks Screening Tool ES
Form 0702, Fax Cover Sheet for TxHmL and HCS
Form 8665-ID, Individual Data
Form 8665, Person-Directed Plan ES
Form 8612, TAS/MHM Payment Exception Request ES
Form 8611, Pre-Enrollment MHM Authorization Request
Form 8603, Level of Need (LON) Review/Increase Cover Sheet
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