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Get the free Welcome to Active Care Atlanta (Child Form)

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6290 Abbott's Bridge Rd, Suite 204 Johns Creek, GA 30097 T: 770.559.4236 F: 770.559.4795 www.ActiveCareAtlanta.com Welcome to Active Care Atlanta (Child Form) Name Birth Date Age Male Female Guardian
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How to fill out Welcome to Active Care:

01
Start by carefully reading through all the sections of the Welcome to Active Care form.
02
Fill in your personal information accurately, including your full name, address, and contact details.
03
Provide any required medical information, such as any existing conditions or allergies that may be relevant to your care.
04
Follow the instructions for indicating your preferred method of communication and providing emergency contact information.
05
If applicable, fill out the section regarding any insurance or payment information that may be required for your care.
06
Review all the filled-out fields for accuracy and make any necessary corrections before submitting the form.
07
Sign and date the form as indicated.

Who needs Welcome to Active Care:

01
New patients or clients who are seeking care and services from Active Care.
02
Existing patients or clients who have had changes in their personal information or medical history since their last visit.
03
Anyone who wishes to receive appropriate and personalized care from Active Care and ensure that their information is up-to-date.
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Welcome to active care is a program designed to provide support and resources to individuals who are transitioning from institutional care to community-based care.
Individuals who are transitioning from institutional care to community-based care are required to file welcome to active care.
To fill out welcome to active care, individuals must provide information about their current care situation, support needs, and preferences for community-based care.
The purpose of welcome to active care is to ensure a smooth transition for individuals from institutional care to community-based care by providing the necessary support and resources.
Information such as current care situation, support needs, and preferences for community-based care must be reported on welcome to active care.
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