Form 3925, Special Needs Funds Request for Communication Access

Instructions for Opening a Form

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.


Effective Date: 5/2017



Updated: 05/2017



The form is used as an application for funding communication access services. The funds are specifically for special events. DHHS staff use the information collected on this form to evaluate the need for Communication Access Real-time Translation (CART) or interpreting services.


Copies and Distribution

No copies.

The original is submitted to DHHS for review at the following address:

Attention: Special Needs Funds
PO Box 12904
Austin, Texas 78711



DHHS retains the application until the end of the fiscal year the application was submitted, and then for three more fiscal years; then the form is destroyed.


Special Instructions

The application should be submitted at least 30 days before the event. The application is evaluated based on criteria outlined in DHHS Services Manual, Chapter 7: Special Needs Funds, 7.3 Selection Criteria.