Get Tx Hhsc T-h1867 2016-2025

The TX HHSC T-H1867 is an important application form for the Healthy Texas Women program, designed to provide women with essential health services. This guide will walk you through the process of completing this form online, ensuring that you submit accurate and complete information.

Follow the steps to successfully complete the TX HHSC T-H1867 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling in your personal information. This includes your first name, last name, middle initial, date of birth, and social security number. Ensure that all names and numbers are accurate.
3. Provide your home address, including street, city, ZIP code, and county. If you have a different mailing address, complete that section too.
4. Enter your driver's license or ID number and a contact phone number where you can be reached.
5. Optional: Indicate your ethnicity and race as per the options provided. Remember, this information is not mandatory.
6. Respond to the questions regarding your citizenship status and health insurance coverage. Include relevant proofs if applicable.
7. Provide details about everyone living in your home, using additional pages if necessary. Include their names, dates of birth, social security numbers, sex, race, and relationship to you.
8. Document all forms of income your household receives. Clearly note the source of income, how often it is received, and the amount.
9. List the expenses your household incurs, including any costs related to child care or alimony. Provide proof as specified in the form.
10. If applicable, have a parent or legal guardian fill out their information and provide a signature if the applicant is aged 15 to 17.
11. At the end of the form, review all entered information for accuracy. Once confirmed, save your changes and either download, print, or share the form as necessary.

Complete the TX HHSC T-H1867 online today for access to vital health services.