Texans can dial 2-1-1 (option 6) for information on COVID-19 and local community resources on health care, utilities, food, housing and more. More COVID-19 information.
Downloading a Form to Your Computer
Fillable forms cannot be viewed on mobile or tablet devices. Follow the steps below to download and view the form on a desktop PC or Mac.
- Right Click for PC or Ctrl + Click for Mac on the PDF link and click “Save link as” from the menu.
- Select the folder you want to save the file in and then click "Save."
- Navigate to the folder you saved the file in and Right Click for PC or Ctrl + Click for Mac, then select "Open With" from the menu and select Adobe Acrobat Reader DC.
Note: Open the PDF file from your desktop or Adobe Acrobat Reader DC. Do not click on the downloaded file at the bottom of the browser since it will not open the PDF in Adobe Acrobat Reader DC. It will try to open the file in the browser that results in the same browser error message.
If still having trouble viewing or downloading a form, click here.
The Batch Cover Sheet is attached to the top of each batch containing more than one Form H1746-A, MEPD Referral Cover Sheet, before being shipped/mailed to the Document Processing Center (DPC).
When to Prepare
Prepare any time more than one Form H1746-A and materials are being shipped/mailed to the DPC in the same package.
Number of Copies
Complete an original.
Attach to the top of each batch being shipped/mailed to the DPC.
Copies may be destroyed when no longer needed.
From — Enter the agency office name, contact name, and contact area code and telephone number in the space provided.
Date — Enter the date the batch is being sent.
Check Boxes — Send all materials to P.O. Box 149024, regardless of transaction type. This form should only have the first checkbox marked, even though the checkbox description states otherwise.
Using the Batch Cover Sheet
- Batch the current day’s documents to be routed to Medicaid for the Elderly and People with Disabilities (MEPD), ensuring that an MEPD Referral Cover Sheet is included for each consumer.
- Attach the Batch Cover Sheet at the top of each bundle and mail via U.S. Postal Service (USPS) to P.O. Box 149024, as instructed.
- Remove materials that do not need to be imaged (for example, Texas Integrated Eligibility Redesign System [TIERS] printouts, generated forms such as appointment notices or receipts, or pages that have already been imaged).
- Follow normal procedures for shipping/mailing via USPS standard mail. The preferred method of mailing is to use the Priority Mail envelopes, which are more durable than manila envelopes. Interagency envelopes should not be used. Do not overstuff envelopes. This often causes them to tear, which could lead to document damage and client confidentiality issues.
- If necessary, work with the supervisor to determine whether to ship/mail the documents in a box or envelope. Do not wait to fill a box or envelope. Documents must be mailed daily.
- If more than one application is sent, each must be faxed individually with one Form H1746-A per application, or mailed using Form H1746-B.
- Do not resubmit previously routed/faxed documents to the vendor for imaging.