Get Vt Form Cfc706 2021-2025

This guide provides clear and detailed instructions on completing the VT Form CFC706 online, designed for individuals referring clients to adult family care homes. Follow the steps below to ensure accurate and efficient submission of the form.

Follow the steps to successfully complete the VT Form CFC706 online.

1. Click the ‘Get Form’ button to access the VT Form CFC706 and open it in your preferred online editor.
2. Begin filling out the referral source information. Provide the date, referral source or agency name, and the contact phone number.
3. List all authorized agencies receiving the referral, including the agency name and contact person for each.
4. Complete the client demographic information, including the client's name, date of birth, mailing address, current location, date of admission, and contact details of the client’s guardian or legal representative if applicable.
5. Indicate the assessed tier for the client based on their care needs.
6. In the client medical care needs section, check all applicable ADLs (Activities of Daily Living) for one-person and two-person assists, as well as medical treatments required for the client.
7. Provide details regarding any mental health diagnosis or behavior plan, indicating if the client needs independent assistance or help with medications.
8. Answer questions on accessibility needs, including wheelchair accessibility and any other specific requirements for the client's living situation.
9. Fill in the client's social history, including any instances of self-neglect, adult protective services involvement, or history of incarceration.
10. Indicate client preferences regarding pets, smoking, and other important information relevant to their care.
11. Review all filled information for accuracy, make any necessary adjustments, and proceed to save your changes.
12. Complete the process by downloading, printing, or sharing the form as per your needs.

Complete your documents online today for a smoother referral process!