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 Insurance In Pima
Category:
State:
Multi-State
County:
Pima
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
In-Home Support Services. Arizona MENTOR's In-Home Support Services are designed to help adults who live with family or other caregivers or on their own succeed in their home environment and participate more fully in community life.
To work as a certified caregiver in Arizona, you must meet the following requirements: Be at least 18 years old. Possess a high school diploma or GED. Complete a caregiver training program approved by the DHS. Pass a written competency exam.
A family caregiver can be someone caring for a spouse or parent, an extended family member, or even a friend or neighbor.
In Arizona, our caregivers are certified with a “Direct Care Worker” certification overseen by the state AHCCCS program. In Colorado, our caregivers meet the state requirements for experience and must pass a hands-on care assessment before coming onto the team.