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HHSC Complaint and Incident Intake Email Self-Report Template

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HHSC Complaint and Incident Intake (CII) reminds providers that an initial self-reported incident can be submitted via the Texas Unified Licensure Information Portal (TULIP) by filling out the CII Self-Report Email Template (PDF) and emailing it to ciicomplaints@hhs.texas.gov or by calling and speaking to an agent at 800-458-9858 (Monday through Friday, 7 a.m.–7 p.m.).

For initial self-reported incidents submitted online, providers can log in to TULIP and submit the findings of the Provider Investigation Report. For initial self-reported incidents submitted by phone, providers can email the report (Form 3613-A/Form 3613) to ciiprovider@hhs.texas.gov or fax to 877-438-5827.