Caregiver Application Form With Social Security Number In Middlesex

State:
Multi-State
County:
Middlesex
Control #:
US-00458BG
Format:
Word; 
Rich Text
Instant download

Description

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.
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  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent
  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent

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FAQ

Division of Aging Services A - K. Adult Protective Services (APS) Aging & Disability Resource Connection (ADRC) ... L - P. Lifeline Utility Assistance. Managed Long Term Services & Supports (MLTSS) ... Q - Z. Senior Gold Prescription Discount Program. State Health Insurance Assistance Program (SHIP)

The Aging in Place program makes accessibility, energy efficiency, and home improvements for seniors (62 and over) of Morris County. The goal is to help seniors live in their own homes longer and maintain their independence.

Health & Wellness Staying Healthy. Medicare. State Health Insurance Assistance Program (SHIP) Pharmaceutical Assistance to the Aged and Disabled (PAAD) program. Senior Gold Prescription Discount Program. Get Flu Ready NJ. Osteoporosis. Hearing Aid Assistance to the Aged and Disabled (HAAAD)

The Stay NJ program offers property tax benefits to eligible homeowners aged 65 and older. It reimburses applicants for 50% of their property tax bills, up to a maximum of $13,000, with a 2024 benefit cap of $6,500.

JACC is a State-funded program that provides a broad array of in-home and community-based services to individuals age 60 and older who meet clinical eligibility for nursing home level of care and who desire to remain in their homes within the community.

The Division of Aging Services uses NJSave, which is one application seniors and individuals with disabilities can use to get help paying Medicare premiums, prescription costs, and other living expenses. People can apply online or via a paper application. Both are available in English and Spanish.

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Caregiver Application Form With Social Security Number In Middlesex