The .gov means it’s official.
State and federal government websites often end in .gov. Before sharing sensitive information, make sure you’re on an official government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Some forms cannot be viewed in a web browser and must be opened in Adobe Acrobat Reader on your desktop system. Click here for instructions on opening this form.
Note: This is a secure form and is not available through this site. Form H1064 will be sent to CHIP households that are eligible to receive CHIP continued enrollment until their request for review is processed. H1064 will only be accessible to the HHSC request for review staff.
An official State of Texas website.