Skip to main content
Skip to left sidebar content
This is the new HHS Forms and Handbooks website. Please update your bookmarks.
Texas flagAn official State of Texas website.
  • HHS Providers Home
Forms and Handbooks
  • Forms
  • Handbooks
  1. Home
  2. Handbooks
  3. Fair and Fraud Hearings Handbook
  4. FFHH Forms
    • Fair and Fraud Hearings Handbook
      • Introduction and Purpose
      • Mission Statement
      • 1000, Fair Hearings
      • 2000, Fair Hearing Decision Reviews
      • 3000, Reserved for Future Use
      • 4000, Administrative Disqualification Hearings
      • FFHH Appendices
      • FFHH Forms
      • FFHH Documents
      • FFHH Revisions
      • FFHH Frequently Asked Questions – Client
      • FFHH Contact Us

FFHH Forms

  • Printer-friendly version

ES = Spanish version available.

Title
Form H4800, Fair Hearing Request Summary
Form H4800-A, Fair Hearing Request Summary (Addendum)
Form H4800-ADH, Request for Administrative Disqualification Hearing
Form H4803, Notice of HearingES
Form H4806, Request for Another Appointment — Request to Withdraw
Form H4807, Action Taken on Hearing Decision
Form H4833, Appeals InformationES
Form H4851-C, Notice of Administrative Disqualification Hearing
Form H4855, Statement of Household Member's Rights in Administrative Disqualification HearingES
Form H4856, Request for Another Appointment for Administrative Disqualification Hearing
Form H4857, Notice of Decision, Administrative Disqualification Hearing
Form H4861, Receipt of NoticeES
  • Compact with Texans
  • File Viewing
  • Notice of Privacy Practices
  • Report Fraud, Waste or Abuse
  • Statewide Search
  • Texas.gov
  • Texas Homeland Security
  • Texas Veterans Portal
  • Website Policy

© Copyright 2016-2026. Texas Health and Human Services Commission. All rights reserved.

Back to top