Dads form 2192-2025

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4.8 out of 5

102 votes

The document is Form 2192 from the Texas Department of Aging and Disability Services, which serves as a certification regarding licensure requirements for Home and Community Support Services Agencies (HCSSAs). It includes a series of yes/no questions to verify the agency's compliance with licensure criteria, such as holding the correct category of licensure, conducting health surveys, eligibility for renewal, and service provision metrics. The form requires an authorized representative's signature and notarization to certify the accuracy of the provided information.

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Versions	Form popularity	Fillable & printable
2013	4.8 Satisfied (102 Votes)

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