TX HHS Form 2327-A. Room and Board Amendment to the Individual or Member and Provider Agreement

The TX HHS Form 2327-A, "Room and Board Amendment to the Individual or Member and Provider Agreement", is a crucial document used to amend the monthly amount of room and board in an individual's or member's agreement with their provider. This form helps solve the problem of updating the financial responsibilities between the parties involved.

This amendment requires providing specific information, including the new monthly amount of room and board, the effective date of the change, and a brief explanation for the modification. The form also outlines the individual's or member's monetary responsibilities, which may include payment of room and board, personal items, clothing, burial expenses, medications, and medical expenses.

The Room and Board Amendment should be used when there is a need to modify the existing agreement between an individual or member and their provider. The form must be signed by all parties involved, including the individual or member, the provider, and any authorized representatives or witnesses. By using this form, individuals or members can ensure that their financial responsibilities are accurately reflected in their agreement.