Caregiver Form Application With Database In Texas

State:
Multi-State
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

A caregiver must: (1) Be at least 18 years of age; (2) Have a high school diploma or its equivalent, and upon request verify completion of any high school equivalency program with original documentation to us. (3) Meet the requirements in Subchapter F of Chapter 745 of this title (relating to Background Checks);

Understand training requirements for Texas Home Health Aides (HHAs) need 120 hours of certification training and 12 hours annually thereafter. CareAcademy offers annual training for HHAs. Certified Nursing Assistant (CNAs) need 120 hours of certification training and are not required to take annual training.

Eligibility Guidelines In order to qualify for IH/FSP, Texas residents must be over 4 years old. They must have a physical disability, as determined by a medical doctor, which functionally limits their ability to live independently. However, the majority of grants are given to persons 65 years and older.

Texas Community Care for Aged/Disabled: Non-Medicaid Services for the Elderly Individuals must be residents of Texas. Individual must be 18+ years old. Monthly income cannot exceed three times the Supplemental Security Income (SSI) payment. Assets and resources (as of 2018) for a single individual cannot exceed $5,000.

A caregiver must: (1) Be at least 18 years of age; (2) Have a high school diploma or its equivalent, and upon request verify completion of any high school equivalency program with original documentation to us. (3) Meet the requirements in Subchapter F of Chapter 745 of this title (relating to Background Checks);

More info

This form is used to collect initial intake information for applicants for Older Americans Act caregiver services. HHSC Staff — Enter the name of the person completing the CSQ.Date — Enter the date the information is being collected. Call the Caregiver Support Line at ( TTY: 711 ) and ask for help filling out the form. How to fill out the Texas Health Human Services Caregiver Intake Form? 1. Gather required personal and care recipient information. 2. Become a paid caregiver through a state Medicaid program. If you need assistance with completing the application or would like to check the status of your 1010CG application please call 18552603274. Is a leading Texas-based provider of services to adults with intellectual and developmental disabilities (IDD). Is a leading Texas-based provider of services to adults with intellectual and developmental disabilities (IDD).

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

Caregiver Form Application With Database In Texas