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Get the free Assisted Living Waiver Program Provider Agreement - dhcs ca

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State of California Health and Human Services Agency Department of Health Care Services TOBY DOUGLAS DIRECTOR EDMUND G. BROWN JR. GOVERNOR Assisted Living Waiver Program Provider Agreement Name of
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Assisted living waiver program is a program that provides assistance to individuals who need help with daily activities and want to live in a community setting.
Individuals who are seeking assistance with daily activities and wish to live in a community setting are required to file for the assisted living waiver program.
To fill out the assisted living waiver program, individuals must complete the application form with their personal information, medical history, and level of need for assistance.
The purpose of the assisted living waiver program is to provide support and assistance to individuals who need help with daily activities but want to maintain independence and live in a community setting.
Information such as personal details, medical history, level of need for assistance, and preferred living arrangements must be reported on the assisted living waiver program.
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