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.

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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]

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]
 
 

Search a complete listing of all

Texas State Forms at https://www.hhs.texas.gov/regulations/forms