Forms & Worksheets

The HHSC CRCG team creates various documents and tools to help support local CRCGs. This page includes forms and worksheets that CRCGs can use as is or adapt to meet their CRCG's unique needs.

Forms

People are connected to local CRCGs through a referral. Local CRCGs may use this form as their referral form, adapt it to meet their needs, or create their own. To download a copy of the Referral Form, click on the link below:

Confidentiality

The CRCG Confidentiality Agreement form is intended to be signed by all CRCG leaders, members and participants, agreeing to safeguard confidential information for the purpose of CRCG-related duties, prior to attending a CRCG staffing. A confidentiality policy document can be found below with additional guidance about CRCG confidentiality procedures.

Consent and Release of Information

CRCGs must comply with applicable state and federal confidentiality laws, as well as individual agency policies. As a potential referral source, members must follow specific procedures for releasing information. If representatives have questions about the appropriate procedure, forms, or protocol for securing releases, it is important they seek direction from within their own agency. Prior to the referral, the referring entity must have written permission from the individual or parent or legal guardian (as appropriate) to share information with the CRCG. The CRCG must obtain consent from the individual, parent or legal guardian (as appropriate) to participate in the CRCG meeting.

The Information for Your CRCG Meeting form helps individuals and families prepare for and understand the CRCG meeting process. Review the form with the individual and family and provide a copy that includes staffing and contact information.

Local CRCGs create Individual Service Plans (ISP) in partnership with the people they serve and provide a copy to the individual or family at the end of a meeting. Local CRCGs may use this form as their individual service plan, adapt it to meet their needs, or create their own. To download a copy of the Individual Service Plan Form, click on the link below:

Use this template to help welcome your new CRCG members and provide them with training resources to help them understand and learn their new role. Local CRCGs may use this as a template, add other relevant information, or create their own welcome email.

Worksheets

The “CRCG Checklist” is a condensed guide to help prepare new or expanding CRCGs to serve their community. The checklist helps CRCGs identify key partners, provides important questions to discuss during your organizational meeting, and helps you establish the structure of your CRCG.

Use this worksheet to help identify and recruit organizations and people essential to CRCG membership.

Use this worksheet to identify which tasks need to be filled for your CRCG and ask members to be responsible for one or more.

The Referral Eligibility Chart is used to determine whether a CRCG can help a person or family with unmet needs. The chart will ask questions and offer guidance to the appropriate services, if relevant.

Bylaws are policies and procedures developed by the CRCG that establish the CRCG's organizational structure. Having a defined organizational structure can help ensure that the CRCG operates smoothly, even during unexpected situations. Creating the CRCG's organizational structure as a group can help increase member buy-in and participation. Use this worksheet and template with your CRCG to help you create your bylaws.

Contact Us

Have a question? Want to get in touch? The HHSC CRCG team would love to hear from you, provide you with more information and answer any questions you may have. Here's how you may reach us:

HHSC CRCG team
P.O. Box 13247
MC 2018
Austin, Texas 78711
Tel: 512-206-5255
Email: CRCG@hhsc.state.tx.us