TX HHS Form 4116-MHM-AA. Minor Home Modification and Adaptive Aids Summary Sheet

The TX HHS Form 4116-MHM-AA, Minor Home Modification and Adaptive Aids Summary Sheet, is a crucial tool for healthcare professionals and caregivers to document minor home modifications and adaptive aids provided to individuals with disabilities. This form helps solve the problem of ensuring that necessary adjustments are made to an individual's living environment to promote independence and safety.

This summary sheet requires information on the type of modification or aid, its purpose, and the individual's needs. It also outlines responsibilities for follow-up actions and specific procedures for implementation. The form is typically filled out by healthcare professionals, caregivers, or social workers in situations where minor home modifications are necessary to support an individual's daily living activities. Key points include:

• The form is used to document minor home modifications and adaptive aids provided to individuals with disabilities.
• It requires information on the type of modification or aid, its purpose, and the individual's needs.