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People in Texas interested in Kidney Health Care (KHC) program benefits must partner with their social worker where they can get care and treatment for their end-stage renal disease (ESRD). This form is used by the social worker to submit the application on behalf of the person.
Kidney Health Care is a statewide program that helps Texans with end-stage renal disease pay for their treatment, including dialysis treatments, access surgery, drugs, travel to transplant or dialysis services and medicare premiums.
Title: Form 3035, Kidney Health Care Program Application Author: Texas Health and Human Services Created Date: 7/13/2018 5:11:17 PM
1 lip 2021 · Download Fillable Form 3035 In Pdf - The Latest Version Applicable For 2024. Fill Out The Kidney Health Care Program Application - Texas Online And Print It Out For Free. Form 3035 Is Often Used In Kidney Health, Healthcare Programs, Texas Health And Human Services, Texas Legal Forms, Legal And United States Legal Forms.
The only requirements to enroll in this program are: the recipient must be a U.S. citizen, legal resident of the state of Texas, and they must get regular dialysis treatments or have received a kidney transplant.
Applying is easy! See the links below to download and complete an application packet and return it to us by email, fax or mail. You may also ask for an application packet from your dialysis social worker or request for one to be mailed to you by calling our main office at 817-250-2443.
please complete this application and return by mail, fax, or email to: Texas Health Harris Methodist Hospital Fort Worth Kidney Transplant Program 1325 Pennsylvania Avenue, Suite 450 Fort Worth, Texas 76104 For questions, please call 817-250-2443 or 800-411-2443. Fax: 817-250-5136 Email: THFWKidneyTransplant@TexasHealth.org
