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 8648, Identification of Preferences ES
Form 8630, Local Intellectual and Developmental Disability Authority (LIDDA) Continuity of Care
Form 8592, Deadline Notification ES
Form 8578-CFC, Intellectual Disability/Related Condition Assessment for CFC
Form 8571, Request to Change Interest List Information for Home 
and Community-based Services (HCS) or Texas Home Living (TxHmL)
Form 1595, Billing Resolutions Request
Form 1070, Offer of Texas Home Living Program ES
Form 1069, Withdrawal of Offer of Texas Home Living Program ES
Form 1068, Withdrawal of Offer for Home and Community-based Services (HCS) Program ES
Form 1067, Offer of Home and Community-based Services (HCS) Program ES
Form 1058, Request for Home and Community-based Services Crisis Diversion Slot
Form 1052, Public Provider Choice Request ES
Form 1049, Initial Documentation of Provider Choice ES
Form 1045, Request for Extension of Enrollment Offer Due Date
Form 1019, Opportunity to Register to Vote/Declination ES