Revised HCS, CLASS, DBMD, TxHmL Forms –  Includes HCS Transportation, TAS, and Pre-Enrollment Minor Home Modifications

DADS has published the following revised forms related to transportation, transition assistance services (HCS only), and pre-enrollment minor home modifications (HCS only). Please begin using the current versions of these forms during the service planning process. As the agency continues to release new or revised forms, providers will be notified.

Revised forms:

• Form 3595 – IPP Service Review
• Form 3598 – Individual Transportation Plan
• Form 3608 – Individual Plan of Care (IPC) – HCS/CFC
• Form 3621 – CLASS/CFC – Individual Plan of Care
• Form 3621-T – CLASS/CFC – IPC Service Delivery Transfer Worksheet
• Form 6500 – Individual Plan of Care (IPC) – DBMD/CFC
• Form 6500-T – IPC Service Delivery Transfer Worksheet
• Form 6501 – Individual Program Plan
• Form 8582 – Individual Plan of Care – TxHmL/CFC

Email questions to CfcPolicy@dads.state.tx.us.

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