Form 4122 is used by Texas Health and Human Services Commission (HHSC) staff and Home and Community-based Services (HCS) Waiver program providers to document a service event for the host home/companion care service component.

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Form 4122 May 2022-E. Home and Community-based Services . Host Home/Companion Care Service Delivery Log. Individual Name (First, Last) Location. Local Case No. Week Of At the end of the day, initial all items that you completed with the individual. If there were any incidents, concerns or special events, document on the bottom of the form ...

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2025年3月22日 · Track American Airlines (AA) #4122 flight from Wilmington Intl to Dallas-Fort Worth Intl Flight status, tracking, and historical data for American Airlines 4122 (AA4122/AAL4122) including scheduled, estimated, and actual departure and arrival times.

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The electronic application intake system, Medicare Electronic Application Request Information System (MEARISTM), is available for Section 4122 application submissions, with application …