ES = Spanish version available.

Form Title
0003 Authorization to Furnish Information
1579 Referral for Relocation Services
1580 Texas Money Follows the Person Demonstration Project Informed Consent for Participation
1581 Consumer Directed Services Overview ES
1582 Consumer Directed Services Responsibilities ES
1582-SRO Service Responsibility Option Roles and Responsibilities ES
1583 Employee Qualification Requirements ES
1584 Consumer Participation Choice ES
1585 Acknowledgement of Responsibility for Exemption from Nursing Licensure for Certain Services Delivered through Consumer Directed Services ES
1586 Acknowledgment of Information Regarding Support Consultation Services in the Consumer Directed Services (CDS) Option ES
1740 Service Backup Plan ES
1741 Corrective Action Plan ES
1826-D Case Information Release
2406 Physician Recommendation for Length of Stay in a Nursing Facility ES
2416 Minor Home Modifications and Adaptive Aids Service Authorization
2442 Notification of Interest List Release Closure ES
2600-A MDCP Waiver Release Letter - Medical Assistance Only ES
2600-B MDCP Waiver Release Letter - Supplemental Security Income ES
2601 Physician Certification ES
2602 Managed Care Organization Selection Acknowledgement ES
2603 STAR Kids Individual Service Plan (ISP) Narrative ES
2604 STAR Kids Individual Service Plan - Service Tracking Tool ES
3618 Resident Transaction Notice
H1097 Affidavit for Citizenship/Identity ES
H1746-A MEPD Referral Cover Sheet
H2053-B Health Plan Selection ES
H2065-D Notification of Managed Care Program Services ES
H2067-MC Managed Care Programs Communication
H1200 Application for Assistance – Your Texas Benefits
H3034 Disability Determination Socio-Economic Report ES
H3035 Medical Information Release/Disability Determination ES
H3676 Managed Care Pre-Enrollment Assessment Authorization
H4800 Fair Hearing Request Summary
H4800-A Fair Hearing Request Summary (Addendum)
H4803 Notice of Hearing
H4807 Action Taken on Hearing Decision