TX HHS Form 3107. Resident Site Modification Waiver and Agreement

The TX HHS Form 3107, Resident Site Modification Waiver and Agreement, is a document used to modify or install equipment at a participant's residence or property. This form helps solve the problem of needing to make changes to existing equipment or installing new equipment as part of the Comprehensive Rehabilitation Services (CRS) Program.

This agreement requires participants to provide specific information, including their name, social security number, and address. The participant must also agree to be responsible for any necessary repairs and/or maintenance of the equipment while it is in their possession. Additionally, the form outlines conditions under which CRS may pay for repairs or maintenance if the participant is financially unable.

The agreement also includes provisions for termination, allowing either the participant or CRS to terminate the agreement with 30 days' written notice. Upon termination, CRS may remove the equipment and restore the premises to its original condition. The form should be used when a participant needs to modify or install equipment as part of their participation in the CRS Program.