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 H4837, Fair Hearings Evidence Packet Cover Letter ES
Form SSA-2853, Message From Social Security
Form 8205, Exhibit D Electroconvulsive Therapy Equipment Registration
Form H1088, Verification of Parenting Skills Training ES
Form H1086, School Attendance Verification
Form H1084, Certification for Warrants Lost, Destroyed, Stolen or Not Received ES
Form H1079, Qualifying Quarters of Social Security Earnings
Form H1077, Notice of TANF Federal Time Limits ES
Form H1076-B, Notice of TANF State Time Limit Months Used/Changed/Corrected
Form H1076-C, Notice of End of TANF State Time Limit/Hardship Exemption
Form H1076-A, Notice of TANF State Time Limits
Form H1074, SNAP Force Change Request
Form H1071, Family Violence Exemption for Medicaid and CHIP ES
Form H1065, Tuition and Fee Exception Letter
Form H1064, CHIP Continued Enrollment Letter ES