RENEWAL APPLICATION General Information: Use this form when submitting a renewal. PROJECT INFORMATION Protocol Number: Protocol Title: INVESTIGATOR INFORMATION Name: MD Position Title: PhD Other:.

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How to fill out the TX Harris County Hospital District Renewal Application online

This guide will provide you with clear, step-by-step instructions for completing the TX Harris County Hospital District Renewal Application online. It is designed to assist users of all experience levels in navigating the form effectively.

Follow the steps to complete your renewal application online.

  1. Press the ‘Get Form’ button to access the TX Harris County Hospital District Renewal Application and open it for editing.
  2. In the General Information section, enter the protocol number and the protocol title of your study.
  3. Fill in the Investigator Information. Provide the name of the investigator, their degrees (e.g., MD, PhD), position title, and any other roles such as student. Include the department and mailing address, then list the city, state, and zip code.
  4. Provide the investigator’s contact information, including phone, fax, pager, and email address.
  5. If there are co-investigators, include their names and relevant information.
  6. In the Study Coordinator section, repeat the process for entering the details of the study coordinator, including name, title, mailing address, and contact information.
  7. When you reach the Renewal Information section, indicate if recruitment is active. If it is not, provide a justification for why the study should remain active.
  8. Indicate whether any changes have been made since the last approval. If yes, prepare to submit the approval letter and details of the approved changes.
  9. Provide the total number of HCHD patients enrolled since the last approval, as well as a general summary of the total number of HCHD patients enrolled.
  10. Summarize any interim findings, amendments, and/or publications that have occurred since the last approval.
  11. If there have been any adverse events reported, provide a description as requested.
  12. After completing all sections, review the information for accuracy. You can save your changes, download the completed form, print it for records, or share it as needed.

Begin filling out your TX Harris County Hospital District Renewal Application online today!

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What is the Harris County Financial Assistance Program 2023?

Harris County Program Targets Most Needy Zip Codes for Financial Safety Net. The Uplift Harris pilot program, approved by the Harris County Commissioners on June 6, 2023, will provide supplemental income to thousands of families living 200% below the poverty line — approximately $60,000 for a family of four.

If you have questions regarding eligibility and how to apply or renew, call the Eligibility Call Center at 713-566-6509.

For households located within Harris County that meet eligibility requirements. One-time $1,500 payment. Funds may be used for any emergency expenses such as healthcare, rent or mortgage, utilities, food, internet, transportation, childcare, and other past due expenses.

The Harris Health System, previously called the Gold Card, helps people with low or no income get quality health care. If you are uninsured, the Harris Health System is a way for you to find affordable, sliding-scale healthcare.

About 1,500 low-income families in Harris County will get $500 a month for 18 months as part of a new pilot project that puts the county squarely in the middle of a roiling national debate about how best to address stubborn poverty.

Harris Health Financial Assistance Program (Gold Card) Texas I.D. or drivers license stating the person lives in Harris County. Social Security Card. Citizenship(Passport or Birth Certificate) or Green Card. Proof of income (1 months check stubs) Any bills or bank statement (within 60 days) Income tax (if necessary)

The gold card is not health insurance, rather it allows you to get discounted pricing on healthcare on a sliding scale. So depending on your income, you will be placed into one of four classifications (Group I-IV) that have different discounted costs.

If approved, the 18-month-long program looks to help residents in economically disadvantaged areas of Harris County recieve $500 a month to help meet basic needs like rent, groceries, or child care.

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