Get Initial Substitute Caregiver Approval Request Form

Completing the Initial Substitute Caregiver Approval Request Form is a crucial step in becoming an approved Substitute Caregiver with Community Ties of America. This guide provides clear, step-by-step instructions to help you fill out the form accurately and efficiently.

Follow the steps to complete the form online

1. Click 'Get Form' button to obtain the Initial Substitute Caregiver Approval Request Form and open it in your preferred editor.
2. Begin by entering the applicant's name and phone number in the designated fields. Ensure the information is accurate and legible.
3. Fill out the mailing address of the applicant. Include the complete address to facilitate communication.
4. Provide the date of birth and age of the applicant. This information is essential for identification purposes.
5. Indicate whether the applicant is a NA, CNA, LPN, RN, or a Substitute Caregiver with less than three hours of experience by circling the appropriate option.
6. Next, enter the name of the Primary Caregiver for whom the applicant will be working. Include their address as well.
7. Specify the number of clients that the Primary Caregiver is certified to care for, as this is crucial for determining the need for Substitute Caregivers.
8. Attach all necessary documents as outlined in the form: government-issued ID, relevant certification, tuberculosis clearance, training certificates, and background checks.
9. In the signature fields, the Primary Caregiver should sign and date the form, acknowledging their responsibilities. The applicant must also sign, verifying their understanding of the requirements and their ability to communicate effectively.
10. After completing all fields and ensuring everything is filled out accurately, you can save changes, download, print, or share the form as required.

Complete the Initial Substitute Caregiver Approval Request Form online today to start your journey towards becoming an approved caregiver.