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Employer & Employee Forms
Here is a list of publicly available forms used in the CDS option.
If you would like a copy of a complete Employer or Employee Packet please contact your CDS Consultant at In-Home Attendant Services.

Employee Forms
[1724] New Employee Packet Cover Sheet | [Download PDF] |
[1725] Criminal Conviction History and Registry Checks | [Download PDF] |
[1729] Applicant Verification for Employees | [Download PDF] |
[1734] Service Provider and Employer Certification of Relationship Status for CDS | [Download PDF] |
[I-9] Employment Eligibility Verification USCIS | [Download PDF] |
[1728] Liability Acknowledgement | [Download PDF] |
[W-4] 2022 Employee’s Withholding Certificate | [Download PDF] |
Texas Employer New Hire Reporting Form | [Download PDF] |
[1730] Wage and Benefits Plan Employee Compensation | [Download PDF] |
[1731] Employee Work Schedule and Assigned Tasks | [Download PDF] |
[1737] Employer and Employee Service Agreement | [Download PDF] |
[1739] Service Provider Agreement | [Download PDF] |
[1727] Occupational Exposure to Bloodborne Pathogens | [Download PDF] |
[1733] Employer and Employee Acknowledgement of Exemption from Nursing Licensure for Certain Services Delivered through Consumer Directed Services | [Download PDF] |
[1732] Management and Training of Service Provider | [Download PDF] |
[1732-EMR] Management and Training of Service Provider Addendum | [Download PDF] |
IHAS System of Payroll | [Download PDF] |
IHAS Calendar | [Download PDF] |
Texas Employer New Hire Reporting Form (Spanish) | [Download PDF] |
Employer Forms
[8821] Tax Information Authorization | [Download PDF] |
[1736] Documentation of Employer Orientation by FMSA | [Download PDF] |
[1720] Appointment of a Designated Representative | [Download PDF] |
[1725] Criminal Conviction History and Registry Checks | [Download PDF] |
[SS-4] Application for Employer Identification Number | [Download PDF] |
[8822-B] Change of address or Responsible Party-Business | [Download PDF] |
[2678] Employer/Payer Appointment of Agent | [Download PDF] |
[C-1] TWC Status Report Form | [Download PDF] |
[C-42] TWC Written Authorization Form | [Download PDF] |
[1726] Relationships Definition in CDS | [Download PDF] |
[1735] Employer and FMSA Agreement | [Download PDF] |
[1722] Employer's Selection for Electronic Visit Verification | [Download PDF] |
[1741] Corrective Action Plan | [Download PDF] |
Employee Forms
Employer Forms
Search a complete listing of all
Texas State Forms at https://www.hhs.texas.gov/regulations/forms
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