FORMS

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Employee Enrollment Forms and Instructions

Enrollment Packets
Employee Enrollment Packet (single-sided) ๐ŸŒ

Payroll-Related Forms and Information

Consumer Direct Care Network EVV Attestation of Service Delivery/EVV Visit Maintenance and Time Correction
แžŸแŸ†แžŽแžฝแžšแžŠแŸ‚แž›แžŸแžฝแžšแž‡แžถแž‰แžนแž€แž‰แžถแž”แŸ‹แžขแŸ†แž–แžธ W-2

Vendor Payment Form

Consumer Direct Care Network Vendor Payment Form

แž€แžถแžšแž‘แž‘แžฝแž›แžแžปแžŸแžแŸ’แžšแžผแžœแž“แŸƒแž€แžถแžšแž•แŸ’แž‘แŸ€แž„แž•แŸ’แž‘แžถแžแŸ‹แž€แžถแžšแž˜แž€แž›แŸแž„แžแžถแž˜แž”แŸ’แžšแž–แŸแž“แŸ’แž’แžขแŸแžกแžทแž…แžแŸ’แžšแžผแž“แžทแž€ (EVV)

Employer's Selection for EVV Responsibilities (HHSC Form 1722)
แž”แž„แŸ’แž€แžพแžแž€แžถแžšแžŸแŸ’แž‘แž„แŸ‹แž˜แžแžทแž˜แžแžทแž”แŸ’แžšแžแžทแž€แž˜แŸ’แž˜แžšแž”แžŸแŸ‹แžขแŸ’แž“แž€แž”แŸ’แžšแžพแž”แŸ’แžšแžถแžŸแŸ‹แž•แŸ’แž‘แžถแž›แŸ‹แžแŸ’แž›แžฝแž“แžšแž”แžŸแŸ‹แžขแŸ’แž“แž€