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 H2067-MC, Managed Care Programs Communication
Form 1344, Texas Vendor Drug Program MCO Search Update Request
Form 2826, Youth Empowerment Services (YES) Waiver Letter of Suspension ES
Form 0021, External Entity Information Security Plan of Action and Milestone
Form 0020, External Entity Information Security Risk Exception Request
Form 2749, Submitting an Application Packet for a Treatment Decision
Form 2720, Certification of Need for Highly Restrictive Procedure
Form 2750, Surrogate Decision Making Program Data Form
Form 2725, List of Persons to Receive Notification of Surrogate Consent Committee Hearing
VR30, Texas Voter Registration Application ES
Form 4211, Respite Funding Agreement ES
Form 1094, PASRR Request for Authorization of IDD Habilitative Specialized Services Cover Sheet
Form H0011-R, Texas Simplified Application Project (TSAP) for SNAP Food Benefits Renewal ES
Form H1010-R, Your Texas Works Benefits – Renewal Form ES
Form 8664, State Hospital System - Data, Research and Publication Request Application