ES  = form also available in Spanish.

1290Long Term Care Claim 
1351Request to Withdraw from the CLASS Application ProcessES
1581Consumer Directed Services Option OverviewES
1582Consumer Directed Services ResponsibilitiesES
1583Employee Qualification RequirementsES
1584Consumer Participation ChoiceES
1586Acknowledgement of Information Regarding Support Consultation Services in the Consumer Directed Services (CDS) OptionES
1720Appointment of a Designated Representative 
1735Employer and  Employer and Financial Management Services Agency Service Agreement 
1739Service Provider Agreement 
1740Service Backup PlanES
1741Corrective Action PlanES
2067Case Information 
2076Authorization to Release Medical InformationES
2432Community Living Assistance and Support Services (CLASS) and Deaf Blind with Multiple Disabilities (DBMD) Vehicle Evaluation 
3591CLASS IPC/IDRC Cover Sheet 
3595IPP Service Review 
3596PAS/Habilitation Plan - CLASS/DBMD/CFC 
3598Individual Transportation Plan 
3599Habilitation Service Provider Orientation/Supervisory Visits 
3621CLASS/CFC - Individual Plan of Care 
3621-TCLASS/CFC - IPC Service Delivery Transfer Worksheet 
3622Denial of Application for CLASS 
3623Approval of Application for CLASS 
3624Termination, Reduction or Denial of CLASS 
3625CLASS/CFC - Documentation of Services DeliveredES
3627Specialized Nursing Certification 
3628Provider Agency Model Service Backup Plan 
3629Individual Program Plan Addendum 
3657Pre-Enrollment Assessment 
3660Request for Adaptive Aids, Medical Supplies, Minor Home Modifications or Dental Services/Sedation 
3849-ASpecifications for Adaptive Aids/Medical Supplies/Minor Home Modifications 
4800-DFair Hearing Request Summary 
4800-DA4800-D Addendum 
6509CLASS/DBMD Coordination of Care 
6515CLASS/DBMD Nursing Assessment 
8001Medicaid Estate Recovery Program Receipt AcknowledgementES
8401Employment First Discovery Tool 
8507Understanding Program Eligibility - CLASS/DBMD 
8557CLASS/DBMD Corrective Action Plan 
8578Intellectual Disability/Related Condition Assessment 
8598Non-Waiver Services 
8601Verification of Freedom of ChoiceES
8604Transition Assistance Services (TAS) Assessment and Authorization 
8605Documentation of Completion of Purchase 
8606Individual Program Plan (IPP) 
8606-ATherapy Justifications - Attachment to IPP 
8662Related Conditions Eligibility Screening Instrument 
H1200Application for Assistance - Your Texas Benefits 
H1350Opportunity to Register to Vote 
H1746-AMEPD Referral Cover Sheet 
H1826Case Information ReleaseES
H3034Disability Determination Socio-Economic ReportES
H3035Medical Information Release/Disability DeterminationES