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- FormsThis form must be maintained as part of the NATCEP records. If the classroom portion of the training is completed online, the NATCEP must have a daily attendance sheet that shows how many hours each student completes each day.
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- FormsThis form is used to collect initial intake information for applicants for Older Americans Act caregiver services.
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- FormsPeople in Texas interested in Kidney Health Care (KHC) program benefits must partner with their social worker where they can get care and treatment for their end-stage renal disease (ESRD). This form is used by the social worker to submit the application on behalf of the person.
- FormsThis form provides the required information per 26 Texas Administrative Code (TAC) minimum standards §744.501(7), §746.501(a)(7), and §747.501(5). Parents will review this policy upon enrolling their child. Employees, household members, and volunteers will review this policy at orientation.
- FormsOperations use this form to record all required information when a child sustains an injury, at the onset of an illness or reportable incident.
- FormsFor prescribing providers to request prior authorization for the Hepatitis C Virus agents. Only use this form for people enrolled in Medicaid fee-for-service.
- FormsAllows a physician to request an initial prior authorization of antiviral agents for Hepatitis C virus treatments. This form is only used for people enrolled in Medicaid fee-for-service.
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- FormsThe following entities must complete and submit Form 1903, Child Support Certification, with their bid or application: sole proprietorships, partnerships, entities with shareholders, or entities with an owner who has an ownership interest of at least 25 percent of the business entity.
- FormsService providers may order any of the forms listed in this order form free of charge. The form must be emailed to HHS Printing Services for processing.
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