Applications and Forms

This page contains applications, forms and directories pertaining to facility licensure . Refer to File Viewing Information on the left-hand side menu to download viewers for PDF files, MS Word documents and Excel files.

• Abortion Facilities
• Ambulatory Surgical Centers
• Birthing Centers
• Community Mental Health Centers
• Comprehensive Out-Patient Rehabilitation Facilities
• End-Stage Renal Disease Facilities
• Hospitals - General & Special
• Hospitals - Waiver Request
• Hospitals - Psychiatric & Crisis Stabilization Units
• Laboratories - CLIA
• Narcotic Treatment Clinics
• Out-Patient Physical Therapy or Speech Pathology Services
• Portable X-Ray Services
• Rural Health Clinics
• Special Care Facilities
• Substance Abuse Facilities
• TMDP- Disclosure and Consent

Abortion Facilities

Notice to Medicaid Women’s Health Program Providers

Section 32.0248, Human Resources Code, prohibits the payment of Medicaid Women's Health Program funds to a provider that performs elective abortions. This provision also applies to licensed abortion facilities. A provider that has performed elective abortions (through either surgical or medical methods) for any patient is ineligible to serve Medicaid Women's Health Program clients and cannot be reimbursed for those services. This prohibition has been in effect since September 1, 2005. This prohibition does not prohibit providers from delivering services to other Medicaid clients. The Health and Human Services Commission may recoup Medicaid Women's Health Program funds that it determines were paid to providers that have performed elective abortions.

For more information please call Kendra Sippel-Theodore, Medicaid/CHIP Division, Health and Human Services Commission, at (512) 491-5594.

Ambulatory Surgical Centers

Birthing Centers

Community Mental Health Centers and
Comprehensive Out-Patient Rehabilitation Facilities

End Stage Renal Disease Facilities

Hospitals - General and Special

Hospitals- Waiver Request

Hospitals - Psychiatric and Crisis Stabilization Units

Laboratories - CLIA

Narcotic Treatment Clinics

Out-Patient Physical Therapy | Speech Pathology Services |
Portable X-Ray Services | Rural Health Clinics

Special Care Facilities

Substance Abuse Facilities

Disclosure and Consent forms

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Texas Department of State Health Services, Health Facillity Licensing Program
1100 West 49th Street - Austin, Texas 78756 - (512) 834-6646

Last Updated September 10, 2009