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, a stock insurance company, herein called the Insurer THE HARTFORD CRIMESHIELDSM ADVANCED POLICY NURSING HOME OR ADULT CARE FACILITIES QUESTIONNAIRE NAME OF INSURED: ADDRESS: DATE: 1. 2. 3. 4. 5.
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How to fill out nursing home or adult:

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Begin by gathering all necessary personal information. This may include the person's full name, date of birth, social security number, contact information, and any other relevant details.
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Next, provide information about the individual's medical history. This can include details about any existing medical conditions, medications they are currently taking, allergies, and previous surgeries or treatments.
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Include information about the person's daily care needs. This may involve noting their mobility level, assistance required for activities of daily living, and any specific medical or dietary restrictions.
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Who needs nursing home or adult:

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Elderly individuals who require consistent medical care and assistance with daily activities may need a nursing home. These may include individuals with chronic medical conditions, limited mobility, or cognitive impairments.
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Adults with physical or cognitive disabilities, who are unable to live independently, may also require care in a nursing home or adult facility.
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Individuals recovering from major surgeries or medical procedures that require ongoing medical supervision and rehabilitation may temporarily need a nursing home or adult care.
It is crucial to consult with healthcare professionals, such as primary care physicians or social workers, to determine the appropriate level of care and whether a nursing home or adult facility is necessary for a specific individual's needs.
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