Get H1826

Filling out the H1826 form is an essential step for individuals seeking assistance with their benefits through the Texas Health and Human Services Commission. This guide provides clear instructions on completing the form online while ensuring that your privacy and information are handled respectfully and securely.

Follow the steps to accurately complete the H1826 form online.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section I, enter your case name and case number (if applicable). This identifies your case to the agency.
3. Read the statement concerning your understanding of the form's purpose. This section confirms that you acknowledge the role of the agency in assisting you.
4. Provide your signature in the designated area to verify your acceptance of the terms provided.
5. Fill out the date next to your signature to indicate when you signed the form.
6. In Section II, specify the individual or agency you authorize HHSC to share your case information with by filling in their name, address, city, state, ZIP code, and telephone number.
7. Select one of the options to identify what information you allow to be shared: either 'Share all of my case record' or 'Share only the following facts from my case record'.
8. Indicate the reason for sharing your case record.
9. Specify the date or conditions when your permission to share this information will end.
10. Sign and date the signature section to confirm your authorization.
11. If signing as a Legally Authorized Representative, check the appropriate box that indicates your relationship to the individual and include your signature and date.
12. If you cannot sign your name, make a mark (X) and ensure that two witnesses sign the form below, noting any reasons if only one witness can be obtained.
13. Complete Section III if you wish to withdraw permission at any time and document your intentions in writing to the Community Partner.

Ensure you complete your documents online today to facilitate your benefits application process.