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 Template With Signature In Wayne
Category:
State:
Multi-State
County:
Wayne
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
The Michigan Department of Health and Human Services/Medical Services Administration (MSA) is responsible for the following medical programs in Michigan: Medicaid. Maternity Outpatient Medical Services (MOMS).
To apply online, you can use a publicly available computer at your local MDHHS office or at a MI Bridges community partner organization. To apply using the paper application, you can find a copy of the application and information booklet on the MDHHS website.
Michigan Medicine is one of the largest hospitals in Michigan and a premier academic medical center made up of: U-M Health. University of Michigan Medical School and its University of Michigan Medical Group practice. One of the nation's largest biomedical research communities.
ESA MISSION: Promote long term economic stability through accessible, timely, and accurate service delivery that maintains the dignity and respect of all involved. Goal: help families achieve self-sufficiency and reduce dependence on public assistance.
The Michigan Department of Health and Human Services (MDHHS) promotes better health outcomes, works to reduce health risks, and supports stable and safe families in Michigan while encouraging self-sufficiency.
How can I apply for caregiver benefits in Michigan? To apply to be a caregiver for a family member, simply reach out to Family Love Care. Family Love Care will then use their expertise to help you through the application process with Michigan Medicaid.