S NAME: ATTENDANT S ADDRESS: (PHONE): ***Hourly Wage Claimed: $ . (Note: Unemployed family members are paid at minimum wage: Employed family members who miss work to provide attendant care are paid an hourly rate equal to their employment or the average rate for attendant care in the area: Professional attendants are paid the actual charge not to exceed $12.50 per hour without prior authorization.).
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How to fill out the FL Attendant Care Form online
Filling out the FL Attendant Care Form online can seem daunting, but with the right guidance, it can be a straightforward process. This guide will walk you through each section of the form to ensure that you complete it accurately and efficiently.
Follow the steps to fill out the FL Attendant Care Form online
- Click ‘Get Form’ button to access the form and open it in the editor.
- Begin by entering the recipient's name in the designated space for 'RE:' and the date in the 'DATE' field.
- In the 'D/A' section, specify the relevant details regarding the attendant care services provided.
- List the services provided in detail under the 'SERVICES PROVIDED' section to ensure clarity.
- Indicate the number of hours per day that the attendant care was rendered in the '# HOURS/DAY' field.
- Calculate the total hours claimed and enter that number in the 'TOTAL HOURS CLAIMED' section.
- The attendant should sign the form in the 'ATTENDANT’S SIGNATURE' field.
- Print the attendant's full name in the 'ATTENDANT’S NAME' field.
- Provide the attendant's address in the 'ATTENDANT’S ADDRESS' section.
- If applicable, include a phone number in the '(PHONE)' field for contact purposes.
- Fill in the 'Hourly Wage Claimed' box with the appropriate amount, making sure to consider the wage guidelines for family members versus professional attendants.
- Review all the information for accuracy, then proceed to save your changes, download, print, or share the completed form.
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