TX HHS Form 3605. HCS Parent or Legally Authorized Representative (LAR) Contact Information for Individuals Under 22 Years of Age

The TX HHS Form 3605, "HCS Parent or Legally Authorized Representative (LAR) Contact Information for Individuals Under 22 Years of Age," is a crucial document that helps ensure timely communication between parents or legally authorized representatives (LARs) and the Texas Health and Human Services Commission (HHSC). This form is used in situations where individuals under the age of 22 are receiving supervised living or residential support through the Home and Community-based Services (HCS) Program.

In accordance with the Texas Government Code, Section 531.1533, this form requires parents or LARs to provide contact information, including name, phone numbers, mailing address, and driver's license information. Additionally, they must sign an acknowledgement of responsibility at the bottom of the form. The form also includes space for emergency contact information and the name of a service coordinator.

The key feature of this form is its emphasis on maintaining accurate and up-to-date contact information. Parents or LARs are responsible for notifying the service coordinator and HCS provider representative of any changes to their contact information. Failure to provide accurate information may result in HHSC referring the case to the Department of Family and Protective Services. Key points to note include:

• The form is used for individuals under 22 years old receiving HCS services.
• Parents or LARs must provide contact information, including phone numbers and mailing address.
• A signed acknowledgement of responsibility is required.
• Changes to contact information must be reported to the service coordinator and HCS provider representative.