HHS forms are used every day to perform tasks such as applying for benefits, contracting to provide goods or services, reporting incidents, declaring end of life wishes, and conducting other business.

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ES = Spanish version available.

Title Last updated
Form 2802, Youth Empowerment Services (YES) Waiver Notice of Participant Rights ES March 21, 2023
Form 2994, Child Placing Agency (CPA) Medication Log March 10, 2023
Form 2993, General Residential Operations Medication Log March 10, 2023
Form 2307, Rights and Responsibilities ES March 1, 2023
Form 2032, Escheatment of Consumer Funds February 27, 2023
Form 2416, Minor Home Modifications and Adaptive Aids Service Authorization ES February 15, 2023
Form 2974, Request for Risk Evaluation Based on Past Criminal History or Central Registry Findings February 14, 2023
Form 2971, Child Care Regulation Request for Background Check ES February 3, 2023
Form 2960, Application for a License to Operate a Residential Child Care Facility January 17, 2023
Form 2870, Permission to Disclose Protected Health and Other Confidential Information November 28, 2022
Form 2806, Authorization of Youth Empowerment Services (YES) Waiver Services ES November 14, 2022
Form 2407, Informal Dispute Resolution (IDR) Request October 21, 2022
Form 2361, PASRR Specialized Services Fair Hearing Request October 19, 2022
Form 2125, Home and Community-based Service (HCS), Texas Home Living (TxHmL) and Community First Choice (CFC) Implementation Plan October 19, 2022
Form 2442, Notification of Interest List Release Closure ES October 12, 2022