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.
Application Caregiver Form With Two Points In Contra Costa
Category:
State:
Multi-State
County:
Contra Costa
Control #:
US-00458BG
Format:
Word;
Rich Text
Instant download
Description
Free preview
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71% of Contra Costa County - California employees would recommend working there to a friend based on Glassdoor reviews. Employees also rated Contra Costa County - California 3.7 out of 5 for work life balance, 3.5 for culture and values and 3.5 for career opportunities.
Simply submit your information, and we'll get back to you about if you qualify for Medi-Cal through Covered California. This is your fastest option if you're interested in signing up for Medi-Cal.
CCHP was the first federally-qualified, state-licensed, county-sponsored HMO in the United States. In 1973, we became the first county-sponsored health plan in California to offer Medi-Cal managed care coverage and in 1976, we became the first county-run HMO to serve Medicare beneficiaries.
In Contra Costa County you can apply for CalFresh in several different ways: Online at BenefitsCal or .GetCalFresh from any computer 24 hours 7 days a week. By telephone (866) 663-3225. Fax an application to (925) 228-0310. Mail an application to any district office listed below.
CCHP is the primary managed-care provider for Medi-Cal beneficiaries in Contra Costa and we also manage smaller plans for county employees and IHSS homecare workers. Our members have access to hundreds of family medicine doctors and specialists in our provider networks.
Orientation locations: 1275 A Hall Ave. 4549 Delta Fair Blvd. You will be instructed as to what date, time and location you are to attend. If you are unable to attend your scheduled orientation please call (925) 363-6680 to reschedule.
Health Plan of San Joaquin (HPSJ) is a publicly sponsored, local non-profit health care plan designed by and for the people of San Joaquin and Stanislaus counties. HPSJ is available for San Joaquin and Stanislaus county residents for Medi-Cal benefits.
Identity Copy of driver's license or photo ID. Social Security Number (actual card) A copy of immigration documentation or card.