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.
Care Caregiver Form Application For Disability In Middlesex
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State:
Multi-State
County:
Middlesex
Control #:
US-00458BG
Format:
Word;
Rich Text
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Contact the Middlesex County Office of Aging and Disabled Services at and ask to speak with someone in Information and Assistance. Transitions of Care; Transportation.Considering In-Home Care? Must be a Middlesex County resident; Must be 65 or older, or have a disability. We also have home care. Guidelines for supporting adults with a developmental disability when applying to, moving into and residing in a longterm care home. Guidelines for supporting adults with a developmental disability when applying to, moving into and residing in a longterm care home. To request in-home personal care services fill out our request form above or call . The JACC program is designed with the goal of avoiding diverting or delaying the placement of the individual in a nursing facility. Use this form to apply for the Program of Comprehensive Assistance for Family Caregivers.