Effective Jan. 5, 2018, the current Form 1576, DBMD Documentation of Provider Choice, will be discontinued and will no longer be listed under the forms section of the DBMD Program Manual.

The form has been replaced by 11 different DBMD Documentation of Provider Choice forms that correspond to each of the 11 HHS regions. These new forms, along with the corresponding regional map, can be found at the following HHS webpage: DBMD Documentation of Provider Choice. The forms will be maintained for each HHS region and will be updated monthly, or as needed.

Email questions to DBMDPolicy@hhsc.state.tx.us.