TX HHS Form 3107. Resident Site Modification Waiver and Agreement

The TX HHS Form 3107, Resident Site Modification Waiver and Agreement, is a crucial document that helps solve the problem of modifying a participant's site for equipment installation. This form is typically used in situations where a Comprehensive Rehabilitation Services (CRS) program participant requires specialized equipment to be installed at their residence or property.

This agreement outlines the key features and responsibilities involved in the modification process. The participant must provide required information, including their name, social security number, and property address. CRS agrees to purchase and install the specified equipment, while the participant is responsible for any necessary repairs and/or maintenance. In the event of financial difficulties, CRS may pay for repairs or maintenance, provided the participant has not abused the equipment or property.

The agreement also includes conditions and follow-up actions, such as CRS's right to enter the listed premises to examine the equipment and take any required action. The participant/owner/lien holder agrees to not sell, mortgage, or dispose of the equipment without CRS's consent. Upon termination of this agreement, CRS may remove the equipment and restore the premises to its original condition. Key points and requirements include:

• The participant must provide necessary information for the modification process.
• CRS agrees to purchase and install specified equipment at the participant's residence or property.
• The participant is responsible for repairs and/or maintenance of installed equipment.
• CRS may pay for repairs or maintenance in cases of financial difficulties, provided the participant has not abused the equipment or property.