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Your Name: Date: Assisted Living Facility (ALF) Level II Online Dementia Care Training Program Module 2 Worksheet: RECOGNIZING PAIN 1. List four verbal or physical signs to look for to recognize when
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To fill out your name date assisted, follow these steps:

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Start by writing your full name in the designated space provided. Make sure to use your legal name as it appears on official documents.
02
Next, fill in the date of assistance. This is the date on which you are receiving or providing assistance.
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Double-check the accuracy of the information you have provided. Ensure that your name is spelled correctly and the date is accurate.
Anyone who is involved in a process where identifying individuals and documenting their date of assistance is necessary requires your name date assisted. This can include medical professionals, social workers, caregivers, administrators, or any other personnel involved in providing assistance or keeping records.
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