Verification Thsteps Checkup Form – Fill Out and Use This PDF

Verification Thsteps Checkup Form PDF Details

Form H1087 (January 2019-E), Verification of Texas Health Steps Checkup, is used when a household applying for assistance from the Texas Health and Human Services Commission has a child whom the TMHP paid claims system shows as overdue for a Texas Health Steps checkup. A Texas Works Advisor or Texas Health Steps staff sends it to the Texas Health Steps Regional Coordinator with the case name, case number and address. For up to two children it lists the name, date of birth and client number, the provider who gave the checkup according to the caretaker, the checkup date and any additional information that could help verify it. The Texas Health Steps worker replies by marking the checkup verified or noting client initiated contact, adds comments and signs. The parent signs to give permission to release the information requested on the form.