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 solve the problem of ensuring accurate and up-to-date contact information for individuals under 22 years old receiving supervised living or residential support in the Home and Community-based Services (HCS) Program. This form should be used by parents or legally authorized representatives (LARs) to provide essential contact information, including phone numbers, mailing addresses, and emergency contacts.

The form requires key information such as the name of the individual receiving HCS services, the parent or LAR's name, home and cell phone numbers, mailing address, and driver's license or personal ID number (if applicable). Additionally, the form asks for employer information and an emergency contact. The parent or LAR must also provide a signed acknowledgement of responsibility at the bottom of the form.

This form is essential in accordance with Texas Government Code, Section 531.1533, which mandates that parents or LARs of individuals under 22 years old receiving HCS services must provide this contact information. The form emphasizes the importance of keeping contact information up-to-date and notifying the service coordinator and HCS provider representative of any changes.