Important: You must be enrolled in Traditional Medicaid before enrolling in CSHCN or Texas Health Steps. Select "Add to an Existing Enrollment," then click "Apply Filters" if you would like instructions for adding CSHCN or Texas Health Steps to your existing enrollment.
Page Filters
These pages will guide you through each stage of the enrollment process using PEP. To customize this page's content, use the filters below and click the Apply Filters button.
Application Type:
Program(s):
Enrolling As:
Provider Information Form (PIF-1) Continued
Instructions for Completing the Provider Information Form (PIF-1) continued.
Conviction Questions: You must answer all of the conviction questions.
If you selected Yes to any of the conviction questions, you must explain the details in the box below the questions. Your explanation should include:
The conviction.
The date.
The state.
The county where the conviction occurred.
Your case number.
You must answer all of the child support questions.
If you selected Yes to the child support question, you must explain how you will meet these past-due payments.
You must provide either documentation that you are currently complying or a court-approved agreement that documents a compliance plan for your child support payments.
Select a country from the “Country of Citizenship” drop-down menu.
Select “Yes” or “No” for “Do you have the legal right to work in the United States.”
If you did not select United States of America as your country of citizenship, you must provide unexpired documentation that demonstrates your right to reside and work in the United States.
