Caregiver Form Application With Database In Pima

State:
Multi-State
County:
Pima
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.
Free preview
  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent
  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent

Form popularity

FAQ

Health information Current prescriptions (be sure to update this regularly) Living will. Durable power of attorney for health care. Copies of any medical orders or forms you have (for example, a do-not-resuscitate order) Health insurance information with policy and phone numbers.

Caregiver Go-Bag Packing List A change of clothes – focus on comfort and don't forget underwear and socks. Toiletries and personal care items, including. Two-day supply of any prescription medications you normally take. At least a day's worth of travel medications like:

Complete a caregiver training program approved by the DHS. Pass a written competency exam. Obtain a fingerprint clearance card from the Arizona Department of Public Safety (DPS) Complete a CPR and First Aid certification course.

Present medical records, witness testimonies, and caregiving logs to the court to prove primary caregiver custody and seek guardianship or conservatorship.

What are common caregiver qualifications? Having relevant work experience and skills. Completing any required training. Passing a background check and general health check. Earning basic health certifications. Meeting age requirements. Possessing a valid driver's license, insurance and a good driving record.

4 legal documents every family caregiver needs A Will. A will is one of the most important legal documents that family caregivers should have. Advance Health Care Plan. Durable Power of Attorney for Health Care. Durable Power of Attorney for Finances.

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.

Description: The Caregiver training course is approved by the Arizona Board of Nursing Care Institution Administrators and Assisted Living Managers (NCIA) and is 62 training hours in length. If successfully completed, the student may take the State Certification exam to become a Certified Caregiver.

Trusted and secure by over 3 million people of the world’s leading companies

Caregiver Form Application With Database In Pima