HHSC

REGISTRATION FORM
Long-Term Services and Supports
Classroom-Based Cost Report Training

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the registration form.
  • Submitting the below registration form does not complete your registration nor guarantee you a seat in the sessions you select.   Once your registration request has been processed, you will receive an e-mail with a confirmation number along with information about the training site for those sessions in which a seat has been reserved for you.  You should receive a reply within 5 business days.

  • You must register at least five business days prior to the training date.

  • You must attend a General training session prior to attending a Specific program session if you are a first time attendee.  If you have a 2013 General Online Certificate you may register for a first time attendee Specific program.

  • There is limited seating for all sessions and registration is on a "first-come, first-served" basis.

  • Submit a separate registration form for each person attending the training.  Reservations will not be accepted by telephone, fax, or e-mail.

  • For questions/assistance with completing this registration form call (512) 730-7402, Monday thru Friday, between 8:30 am and 4:00 pm, Central Time.

Registration ID:
   First Four Letters of your Last Name

   (If your last name does not contain 4 letters, continue with letters from your first name. Example: Ron Lu would be LURO)

Last Four Digits of your Social Security Number:

 

Participants First Name:
   (as desired on training certificate)

 
Participants Last Name:
   (as desired on training certificate)

 

Mailing Address (street, P.O. Box):

City: State: Zip:

      

Daytime Phone Number:
   example: 512-438-5555

     

Fax Number:
   example: 512-438-5555

        

Email Address:
   example: Joe.Smith@myISD.edu

Re-Enter Email Address:

   

If you are willing to be contracted/hired by providers to prepare cost reports, place a checkmark in this box as authorization for HHSC Rate Analysis to give out your name to the public after you have successfully completed training.




General Session
All Programs

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.102 8:00 a.m. to 12:00 p.m.
Arrive by 7:45 a.m.
13-GEN-108
02/25/14 Austin JJ Pickle Research Campus 1.102 8:00 a.m. to 12:00 p.m.
Arrive by 7:45 a.m.
13-GEN-116


CBA HCSS, PHC, and CLASS - (CPC)
Community Based Alternatives-Home and Community Support Services
Primary Home Care
 Community Living Assistance and Support Services

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.122 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-CPC-109
02/25/14 Austin JJ Pickle Research Campus 1.122 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-CPC-117


DAHS
Day Activity and Health Services

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.162 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-DAHS-110
02/25/14 Austin JJ Pickle Research Campus 1.162 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-DAHS-118


DBMD
Deaf-Blind Multiple Disabilities Waiver

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.106 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-DBMD-111
02/25/14 Austin JJ Pickle Research Campus 1.106 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-DBMD-119


HCS/TxHmL & ICF/IID
Home and Community Based Services/Texas Home Living &
Intermediate Care Facilities for Individuals with an Intellectual Disability or Related Conditions

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.138 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-IDD-115
02/25/14 Austin JJ Pickle Research Campus 1.138 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-IDD-123


NF
Nursing Facility

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.140 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m. 
13-NF-112
02/25/14 Austin JJ Pickle Research Campus 1.140 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-NF-120


RC and CBA AL
Residential Care & Community Based Alternatives/Assisted Living

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.164 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-RC-114
02/25/14 Austin JJ Pickle Research Campus
1.164 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-RC-122


24 RCC
24-Hour Residential Child Care

Date

City

Location

Room

Time

Seats

Session Number

Register

01/21/14 Austin JJ Pickle Research Campus 1.130 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-RCC-113
02/25/14 Austin JJ Pickle Research Campus 1.130 1:00 p.m. to 5:00 p.m.
Arrive by 12:45 p.m.
13-RCC-121


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