Instructions: 
1. Click "Buy Now" to download your file
2. Print the file then sign and date page 2 (original signature required).
3. Submit the application to the address provided below.  All required documents must be received by the HHSC Point of Contact by the due date and time listed in the Procurement Schedule in Subsection 1.3 of the open enrollment.​
 

• Physical Address for Delivery
  (Operating Hours – 8:00 A.M. to 5:00 P.M.)
  Health and Human Services Commission
  Attn:  Mental Health Contract Management Unit
  Procurement # HHS0000065
  P.O. Box 149347, Mail Code 2058 
  Austin, Texas, 78714-9347