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DETERMINATION AND FINDINGS FOR CONTRACTOR RESPONSIBILITY AND QUALIFICATIONAgency:Department on Disability Services (DDS)Program:Developmental Disabilities Administration (DDA)Caption:Residential Rehabilitation,
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Step 1: Start by obtaining a copy of form 1901-human care agreement.
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Step 2: Read the instructions and requirements carefully.
03
Step 3: Fill in your personal information such as name, address, and contact details.
04
Step 4: Provide information about the person who requires human care.
05
Step 5: Specify the type and duration of care needed.
06
Step 6: Indicate the responsibilities and duties of the caregiver.
07
Step 7: Sign and date the form.
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Step 8: Submit the completed form to the appropriate authority or organization.

Who needs form 1901-human care agreement?

01
Form 1901-human care agreement is needed by individuals who require or provide human care services.
02
This includes situations where someone is hiring a caregiver for a family member or when a caregiver is entering into an agreement with a care recipient.
03
It helps establish the terms and conditions of the care arrangement and ensures that both parties are clear on their rights and responsibilities.
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Form 1901 - Human Care Agreement is a document used to formalize the terms and conditions of care provided to individuals requiring human care services.
Providers of human care services who are seeking reimbursement or funding for their services are required to file Form 1901.
To fill out Form 1901, individuals must provide personal and service-related information, including the recipient's details, service descriptions, duration, and funding sources.
The purpose of Form 1901 is to establish a clear agreement between care providers and recipients regarding the services to be delivered, payment processes, and compliance with regulations.
Form 1901 must contain information such as care recipient's name, service provider's details, description of services, payment terms, and signatures from both parties.
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