Get Salud Home Care Client Service Agreement Addendum

Filling out the SALUD HOME CARE CLIENT SERVICE AGREEMENT ADDENDUM online can be a straightforward process when guided properly. This addendum is essential for adjusting your care agreement per your physician's recommendations.

Follow the steps to complete your addendum accurately.

1. Click the ‘Get Form’ button to acquire the addendum and open it in your preferred online editor.
2. Start by entering the patient's name in the designated space labeled 'Patient.' Ensure you fill this in accurately to reflect the individual receiving care.
3. Next, input the date in the 'Date' field and provide the corresponding MR # (medical record number) along with the SOC (start of care) number. This information is crucial for effective tracking of services.
4. In the section regarding changes made by the physician, indicate the new frequency of visits. Fill in the empty lines to specify how often services will now be provided, according to the physician's adjustments.
5. Complete the 'Discipline' section by listing the specific disciplines involved in the patient's care. This may include nursing, therapy, or other relevant services.
6. If there are any changes in charges due to the modifications, this is the section to provide that information. Clearly explain the reason for any charge changes or select 'N/A' if it does not apply.
7. Confirm physician approval by checking the appropriate box if the changes were approved by the doctor. Additionally, express acceptance of the changes in the care agreement by checking the next box, providing acknowledgment of receipt.
8. If necessary, fill in any additional comments in the 'Other' section to clarify further any details that might impact the care agreement.
9. Finally, obtain the required signatures. The patient or their representative must sign and date the form in the respective fields, along with an agency representative's signature for confirmation.
10. Once all fields are completed, you can save your changes, download, print, or share the completed addendum as required.

Complete your SALUD HOME CARE CLIENT SERVICE AGREEMENT ADDENDUM online today!