Get the free Extended Care Agreement and Authorization Form 2013-2014 - ststanschicago

1255 N. Noble St. Chicago, IL 60642 p 7732784560 f 7732789097 www.StStansChicago.org Extended Care Agreement and Authorization Form 20132014 Family Name Students Name Grade Birthdate Will you be using:

How to fill out extended care agreement and

How to fill out the extended care agreement:

1. Review the agreement: Begin by carefully reading through the entire extended care agreement. Familiarize yourself with the terms, conditions, and any specific requirements mentioned in the document.
2. Provide personal information: The extended care agreement will likely require you to enter your personal information. This may include your full name, address, contact details, and any other relevant information requested.
3. Specify the duration of care: Indicate the specific dates or time period for which you require extended care. This could be the start and end date, or it may be an ongoing agreement until further notice.
4. Describe the care needed: Clearly explain the type of care you require. List out any particular services or assistance you expect from the caregiver or care facility. Be specific about any medical or behavioral conditions that need to be addressed.
5. Agree on payment terms: Discuss and agree upon the financial aspects of the extended care agreement. This may include the payment amount, frequency, and preferred method of payment. Ensure both parties are clear on the payment terms and any additional costs that may be incurred.
6. Outline expectations and responsibilities: Clearly state the responsibilities of both parties involved. This can include the caregiver's duties, such as meal preparation, medication administration, or transportation, as well as the client's responsibilities in terms of following rules and providing necessary information.
7. Include any special requests or considerations: If there are any specific requests or considerations you have, make sure to include them in the extended care agreement. This could be regarding dietary preferences, daily routines, or any other important details that the caregiver should be aware of.

Who needs an extended care agreement:

1. Individuals requiring additional care: An extended care agreement is essential for individuals who need extra assistance, whether it be due to age-related concerns, medical conditions, disabilities, or other circumstances.
2. Caregivers or care facilities: Caregivers or professionals providing extended care services should also have an extended care agreement in place. This agreement helps establish a clear understanding of their responsibilities, payment terms, and the specific care requirements expected from them.

Both parties benefit from having an extended care agreement as it ensures transparency, helps avoid any misunderstandings, and provides a framework for a successful caregiver-client relationship.

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What is extended care agreement and?

Extended care agreement is a legal document that outlines the terms and conditions of care provided to an individual beyond normal business hours.

Who is required to file extended care agreement and?

Parents or guardians of minors who require extended care services are required to file extended care agreements.

How to fill out extended care agreement and?

Extended care agreements can typically be filled out online or in person with the care provider, following the instructions provided.

What is the purpose of extended care agreement and?

The purpose of extended care agreement is to establish clear expectations and responsibilities for extended care services between the care provider and the parents or guardians.

What information must be reported on extended care agreement and?

Information such as the child's name, age, emergency contacts, medical information, specific care instructions, and agreed-upon schedule must be reported on an extended care agreement.