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

The Texas Health and Human Services (HHS) Form 2123, Adaptive Aid/Minor Home Modification Request for Prior Approval, serves as a crucial tool for individuals seeking prior approval for adaptive aids or minor home modifications. This form enables applicants to provide detailed information about the requested assistance, including the individual's name, CARE ID number, program provider name, and contact details.

The purpose of this form is to facilitate the review and approval process for adaptive aids or minor home modifications that are necessary to ensure the health, safety, and well-being of individuals with disabilities. By submitting Form 2123, applicants can demonstrate compliance with Texas HHS guidelines and regulations, thereby streamlining the application process and ensuring timely access to essential support services.

This form is intended for use by individuals seeking adaptive aids or minor home modifications, as well as program providers who work with these individuals. The information provided on Form 2123 will be used by Texas HHS staff to review and approve requests, ensuring that applicants receive the necessary assistance to maintain independence and quality of life.