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County Record # RELATIVE PROVIDER AGREEMENT APPENDIX D PARENT AND RELATED PROVIDER ATTESTATION OF RELATIONSHIP TO CHILD Parents First Name: Last Name: The information contained in this form is a true

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How to fill out relative provider agreement

01

Step 1: Obtain a copy of the relative provider agreement form.

02

Step 2: Read through the entire agreement to understand the terms and conditions.

03

Step 3: Fill in your personal details such as name, address, contact information, and social security number.

04

Step 4: Provide information about the relative you will be providing care for, including their name, date of birth, and relationship to you.

05

Step 5: Specify the start date and duration of the agreement.

06

Step 6: Review and agree to any additional terms or obligations outlined in the agreement.

07

Step 7: Sign and date the agreement.

08

Step 8: Make a copy of the completed agreement for your records.

09

Step 9: Submit the signed agreement to the relevant authority or organization.

Who needs relative provider agreement?

01

Individuals who will be providing care for their relatives.

02

Families who want to establish formal agreements for caregiver responsibilities within the family.

03

People who want to clarify the roles and expectations of providing care to their relatives.

04

Organizations or agencies that require documentation for caregiver arrangements involving relatives.

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What is relative provider agreement?

Relative provider agreement is a contract between a child care provider and a relative provider.

Who is required to file relative provider agreement?

Relative providers who are caring for children in a child care setting are required to file relative provider agreement.

How to fill out relative provider agreement?

Relative provider agreement can be filled out by providing information about the child care program, the relative provider, and the children in care.

What is the purpose of relative provider agreement?

The purpose of relative provider agreement is to outline the terms and conditions of the child care arrangement between the provider and the relative.

What information must be reported on relative provider agreement?

Information such as hours of operation, fees, emergency procedures, and signatures of both parties must be reported on relative provider agreement.

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