TX HHS Form 2123. Adaptive Aid/Minor Home Modification Request for Prior Approval

The TX HHS Form 2123, Adaptive Aid/Minor Home Modification Request for Prior Approval, is a crucial document that helps individuals with disabilities or special needs obtain necessary modifications to their homes. This form is typically filled out by the individual themselves, or on their behalf by a program provider, to request prior approval for adaptive aids or minor home modifications.

This form requires specific information, including the individual's name, CARE ID number, and contact details, as well as a description of the proposed adaptive aid or minor home modification. The form also outlines the responsibilities of the individual and the program provider in the process. By submitting this form, individuals can ensure that their requests are reviewed and approved before any modifications are made to their homes.

Key features of this form include the requirement for a detailed description of the adaptive aid or minor home modification, as well as the need for prior approval from Texas Health and Human Services (HHS). The following key points summarize the purpose and requirements of this form:

• The form is used to request prior approval for adaptive aids or minor home modifications.
• The individual must provide their name, CARE ID number, and contact details.
• A detailed description of the proposed modification is required.
• Prior approval from HHS is necessary before any modifications can be made.