Forms

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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Title	Last updated
Form 3212, Birthing Center License Application	February 27, 2023
Form 2032, Escheatment of Consumer Funds	February 27, 2023
Form 1338, Cystic Fibrosis Agents (Kalydeco/Orkambi/Symdeko) – Medicaid Standard PA Addendum	February 27, 2023
Form 3071, Individual Election/Cancellation/Update ES	February 24, 2023
Form 8582, TxHmL-CFC Individual Plan of Care	February 24, 2023
Form 6519, Record of Completion for General Orientation Training	February 23, 2023
Form 6518, Record of Completion for Individual Specific Training, Instructions	February 23, 2023
Form 8617, Individualized Skills and Socialization Enhanced Staffing Rate	February 23, 2023
Form 3200, Abortion Facility License Application	February 23, 2023
Form 6520, Record of Completion for the DBMD Program Service Provider Training	February 17, 2023
Form 3232, General or Special Hospital License Renewal Application	February 17, 2023
Form 3087, TMHP Confidentiality Agreement	February 15, 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 8615, On-site and Off-site Individualized Skills and Socialization Service Delivery Log	February 13, 2023