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CDs Extended Care School year 20 20 Student Information Grade Teachers (Please print clearly) Students Full Name: Name child goes by: Street Address: City & Zip code Home Phone: Mother: Work Phone
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How to fill out cbds extended care information
How to Fill Out CBD's Extended Care Information:
01
Start by gathering all relevant personal information such as name, address, contact details, and date of birth.
02
Provide detailed medical history, including any pre-existing conditions or ongoing treatments that could affect your care requirements.
03
Specify the preferred type of extended care, such as assisted living, nursing home, or in-home care.
04
Indicate the level of assistance needed, such as basic personal care, medication management, or specialized medical attention.
05
Fill out any specific preferences or requirements, such as dietary restrictions or language preferences.
06
Provide emergency contact information, including names, phone numbers, and relationships to the individual.
07
If applicable, provide insurance information, including policy numbers and contact details for the insurance provider.
08
Review the completed form for accuracy and ensure all necessary information has been included.
09
Sign and date the form, acknowledging that the information provided is accurate to the best of your knowledge.
Who Needs CBD's Extended Care Information?
01
Individuals with chronic illnesses or disabilities who require ongoing care and support beyond what is typically provided in a regular healthcare setting.
02
Aging adults who may need assistance with daily activities or specialized medical care.
03
Family members or caregivers seeking to explore various extended care options and make informed decisions on behalf of their loved ones.
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What is cbds extended care information?
CBDS extended care information is a form that provides detailed information about the care and services provided to individuals in an extended care facility.
Who is required to file cbds extended care information?
Providers of extended care facilities are required to file CBDS extended care information.
How to fill out cbds extended care information?
CBDS extended care information can be filled out online through the designated portal provided by the healthcare authority.
What is the purpose of cbds extended care information?
The purpose of CBDS extended care information is to track and monitor the quality of care provided in extended care facilities.
What information must be reported on cbds extended care information?
Information such as patient demographics, care plans, medication administration records, and therapy notes must be reported on CBDS extended care information.
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