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 Form Application With Va In Nevada
Instant download
Description
Free preview
Form popularity
FAQ
Use VA Form 10-10CG to apply for the Program of Comprehensive Assistance for Family Caregivers. Each time a new caregiver is appointed, a new VA Form 10-10CG is required.
Use VA Form 10-10CG to apply for the Program of Comprehensive Assistance for Family Caregivers. Each time a new caregiver is appointed, a new VA Form 10-10CG is required.
The Veteran has a VA disability rating (individual or combined) of 70% or higher, and. The Veteran was discharged from the U.S. military or has a date of medical discharge, and. The Veteran needs at least 6 months of continuous, in-person personal care services, and. The Veteran needs to be enrolled in VA health care.
Need Help? To assist you with enrolling in these programs, contact your local VA facility CSP Team/Caregiver Support Team, or call the VA Caregiver Support Line(CSL) at 1-855-260-3274. Subscribe to receive email updates and information about VA Caregiver Support Program services.