Check the program definition before gathering a packet
The Form 3034 instructions require a chronic condition with physical manifestations, not solely an intellectual, mental, behavioral or emotional developmental delay. Ask the evaluating provider and regional program office whether this is the appropriate application process for your family.
The program describes healthcare benefits and case management, including mental health services. That description is useful context, not confirmation that an applicant qualifies or that a particular appointment will be paid. Ask about the application review and any service-specific requirements separately.
Sources: HHSC Form 3034: provider assessment instructions; Texas DSHS: CSHCN program services and regional assistance
Prepare the current applicant form and documents
Start from the current HHSC Form 3031 page. Its instructions say to complete all sections, sign and date the form, and attach the necessary documents. A case manager may help with the application. Ask the regional office for help or language services if completing the packet is difficult.
Follow the document instructions for your situation. For self-employment, the page calls for the most recent tax return showing adjusted gross income, recent expense receipts and the program’s self-employment form. Ask the office for that form rather than substituting an unrelated insurance application worksheet.
Sources: HHSC Form 3031: CSHCN program application instructions
Arrange the evaluating provider’s part
Send the official Form 3034 instructions to the provider’s office and ask how it handles completion. The provider documents the medical assessment and diagnosis information. Do not select or change diagnosis codes yourself to try to satisfy a program requirement.
HHSC requires the form yearly and says incomplete assessments are rejected. Its instructions specify an evaluating provider, an evaluation within the preceding 12 months and acceptable signatures. Ask the office to check all sections and signature requirements before returning its part of the packet.
Send both parts to the correct regional office
The application instructions direct the signed Form 3031, completed and signed Form 3034 and supporting documents to a CSHCN regional office. Use the current form’s office directory or program help contact to confirm the destination and submission method for your application.
Keep a copy of what was sent and a short list of any items still requested. When following up, identify which form or document is unresolved. After a program decision, ask about approved benefits and participating providers before treating the application as authorization for an appointment.
Sources: HHSC Form 3031: CSHCN program application instructions; Texas DSHS: CSHCN program services and regional assistance
Your next-step checklist
- Ask whether CSHCN is the appropriate program application.
- Use the current Form 3031 and requested evidence.
- Arrange the evaluating provider’s Form 3034.
- Check both signatures and all required sections.
- Confirm the regional destination and keep the submission record.
Keep personal, insurance and medical information in the appropriate organization’s approved secure channel.
Common questions
Does an application for mental health care establish CSHCN eligibility?
No. The provider-assessment instructions require a qualifying chronic physical condition; solely mental, behavioral, emotional or intellectual developmental delay does not meet that stated criterion. The program determines eligibility.
Can a case manager help with the application?
Yes. Form 3031 instructions allow case-manager assistance. The provider assessment still needs to be completed and signed according to its own instructions.
Sources: HHSC Form 3031: CSHCN program application instructions; HHSC Form 3034: provider assessment instructions
Sources and verification
The sources below support the administrative information in this guide. Follow the responsible organization’s current instructions when requirements, forms or contact routes change.