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 Suffolk
Category:
State:
Multi-State
County:
Suffolk
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
"Caregiver" means an adult who is a single person with a Virginia adjusted gross income of not more than $50,000, or married and the combined Virginia adjusted gross income of both spouses is not more than $75,000 who provides care for a mentally or physically impaired person within the Commonwealth.
Call the Caregiver Support Line at 855-260-3274 ( TTY: 711 ) and ask for help filling out the form. Find a Caregiver Support Team Coordinator at your nearest VA health facility. Go to our Caregiver Support Program Teams directory. Get help from an accredited representative, like a Veterans Service Organization (VSO).
The Pennsylvania Caregiver Support Program helps people who take care of others. It offers resources and support to make caregiving easier and to keep a good relationship with the person being cared for. The program aims to reduce caregiver stress by focusing on the caregiver's well-being.