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Get the free Board and Care Intake Packet - My Choice Foundation

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Trust Management Services P.O. Box 601676 Sacramento, CA 95860-1676 BOARD & CARE INTAKE PACKET Dear Service Coordinator, Attached you will find our 4-page intake form and the required releases. Please
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How to fill out board and care intake

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How to Fill Out Board and Care Intake:

01
Start by gathering all the necessary information. You will need personal details of the individual requiring board and care, such as their full name, date of birth, address, and contact information.
02
Proceed to the medical history section. Provide accurate information about any pre-existing medical conditions, allergies, medications, and recent hospitalizations or surgeries. Make sure to include any relevant medical documentation, if available.
03
Fill in the social history section. This includes information about the individual's living situation, family support, social activities, and any mental health concerns. Be thorough in providing information that can help in developing an appropriate care plan.
04
Provide details about the individual's daily activities and self-care abilities. This includes information related to bathing, dressing, grooming, eating, mobility, and any assistance needed.
05
If applicable, provide information regarding any special dietary requirements or restrictions. Note any preferences, allergies, or specific instructions related to meal planning and preparation.
06
Include information about the individual's financial situation. This may involve providing details about their source of income, health insurance coverage, and any financial arrangements for the board and care services.
07
Sign and date the intake form once all the required information has been provided. Make sure to review the entire form for accuracy and completeness before submission.

Who Needs Board and Care Intake:

01
Individuals who require assistance with daily activities: Board and care intake is necessary for individuals who need support in performing tasks such as bathing, dressing, grooming, and eating due to physical or cognitive limitations.
02
Individuals with medical conditions or chronic illnesses: Those with pre-existing medical conditions or chronic illnesses may require board and care services to ensure their health needs are properly addressed and monitored.
03
Elderly individuals: Board and care intake is commonly required for elderly individuals who may need assistance in their daily activities or specialized care due to age-related conditions or disabilities.
04
Individuals with mental health concerns: Those with mental health issues or behavioral challenges may benefit from board and care services that provide a structured and supportive environment.
05
Individuals transitioning from a hospital or rehabilitation setting: Board and care intake is often necessary for individuals who are transitioning from a hospital or rehabilitation facility back to their community, as they may require additional support and care during this period.
It is important to note that specific eligibility criteria for board and care intake may vary depending on the facility or program.
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Board and care intake is a process of documenting and reporting the intake of residents in a board and care facility.
Board and care facility administrators or designated staff members are typically required to file board and care intake.
Board and care intake forms are typically filled out with information such as resident name, admission date, medical history, and any special needs or accommodations.
The purpose of board and care intake is to ensure proper documentation of residents entering the facility and to provide necessary information for their care and well-being.
Information such as resident personal details, medical history, medications, allergies, emergency contacts, and special needs must be reported on board and care intake forms.
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