Get Appendix 24 Negotiated Risk Agreement Form - Aging Ca

The Appendix 24 Negotiated Risk Agreement Form is an essential document utilized by the California Department of Aging's Multipurpose Senior Services Program. This guide provides a step-by-step approach to completing the form online, ensuring clarity and ease of understanding for all users.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the client’s last name in the designated field at the top of the form. This information identifies the individual for whom the agreement is being made.
3. Next, fill in the client's first name and middle initial (MI) to provide complete identification.
4. Input the MSSP number, a crucial identifier linking the client to the Multipurpose Senior Services Program.
5. In the section labeled 'Client’s desire/preference', describe what the client wishes to achieve or any personal preferences relevant to their care.
6. Fill out the 'Current situation/cause(s) of concern' section. Identify any issues or situations that have led to the creation of the risk agreement.
7. Articulate the 'Possible/probable negative consequences' that could arise if the identified risks are not addressed adequately.
8. In the section for 'Possible alternatives to minimize risk', propose options that could help mitigate the identified risks, ensuring a proactive approach.
9. Record any 'Final agreement, if any, reached by all parties' in this section, summarizing how all parties involved have agreed to proceed.
10. Specify the 'Frequency of reassessment of risk' to outline how often the risk situation will be reviewed.
11. Finally, ensure that all parties, including the client and care manager, sign their names in the provided signature fields.
12. Add the date of completion in the section marked for the date, ensuring that the document is time-stamped appropriately.
13. Once all sections are filled out, users can save changes, download the completed form, print it for physical copies, or share it as required.

Complete your Appendix 24 Negotiated Risk Agreement Form online today for effective documentation of risk management.