Get Texas Department Of Human Services. Form 1747 - Dads State Tx

Filling out the Texas Department of Human Services Form 1747 can be an essential step in accessing necessary services. This guide provides clear, step-by-step instructions to help users complete this form effectively and confidently.

Follow the steps to successfully fill out the form online.

1. Press the ‘Get Form’ button to obtain the form and open it in your digital interface.
2. Begin by entering the patient’s name in the designated field, ensuring correct spelling and capitalization.
3. Fill in the date of birth for the patient, ensuring the format matches the required specifications.
4. Provide the patient’s social security number in the appropriate section.
5. Indicate the case name of the caregiver responsible for the patient in the corresponding field.
6. Enter the case number assigned to the patient for reference.
7. Document the patient’s usual job, if applicable, or indicate 'not applicable'.
8. Complete the advisor’s name field with the name of the individual assisting with the process.
9. For the office address, be sure to include complete details including mail code and fax number if required.
10. Instruct the physician to fill out Section II by indicating the patient's work abilities, including any restrictions.
11. Provide information related to personal disabilities in Part A, ensuring accurate selections based on the patient’s capabilities.
12. In Part B, specify any activity restrictions that apply to the patient’s workday; check applicable boxes.
13. Document the primary and secondary disabling diagnosis in Part C as provided by the physician.
14. Ensure that the physician’s name, license number, office address, and contact number are accurately entered.
15. Obtain the physician's signature and date to finalize their section of the form.
16. Complete Section III by seeking consent from the patient or their representative for medical information disclosure.
17. After filling the form, users may choose to save changes, download, print, or share the completed document as required.

Start completing your documents online now to ensure timely processing.