This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
Caregiver Application Form With Social Security Number In Bexar
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State:
Multi-State
County:
Bexar
Control #:
US-00458BG
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Word;
Rich Text
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FAQ
If you download, print and complete a paper form, please mail or take it to your local Social Security office or the office that requested it from you.
To request a different Social Security number, contact your local Social Security office for an in-person appointment.
Texas Community Care for Aged/Disabled: Non-Medicaid Services for the Elderly Individuals must be residents of Texas. Individual must be 18+ years old. Monthly income cannot exceed three times the Supplemental Security Income (SSI) payment. Assets and resources (as of 2018) for a single individual cannot exceed $5,000.
Eligibility Guidelines In order to qualify for IH/FSP, Texas residents must be over 4 years old. They must have a physical disability, as determined by a medical doctor, which functionally limits their ability to live independently. However, the majority of grants are given to persons 65 years and older.
Texas' In-Home and Family Support Program (IH/FSP) is also referred as the Community Services IHFS Grant. These grants are intended to provide support to physically disabled individuals who do not also have intellectual disabilities in the interest of preserving their independence.