TX HHS Form 6507. Rationale for Adaptive Aids. Medical Supplies. and Minor Home Modifications

The TX HHS Form 6507, "Rationale for Adaptive Aids, Medical Supplies, and Minor Home Modifications," is a crucial document that helps individuals with Deaf-Blind Multiple Disabilities or other functional limitations obtain necessary adaptive aids, medical supplies, and minor home modifications. This form enables applicants to provide detailed information about their diagnosis/medical condition, functional limitations, and the specific items required to support their treatment, rehabilitation, or daily living.

The form consists of two identical sections (Items 1 and 2) that require applicants to specify the medical supply, adaptive aid, or minor home modification needed. They must also describe why the item is necessary and how it benefits them in terms of treatment, rehabilitation, or compensating for their functional limitations. The applicant's professional, including printed name, telephone number, and signature, must also be provided.

This form should be used by individuals with Deaf-Blind Multiple Disabilities or other functional limitations who require adaptive aids, medical supplies, or minor home modifications to support their daily living. It is essential for applicants to provide detailed information about their diagnosis/medical condition, functional limitations, and the specific items required to ensure that their needs are accurately assessed and met.