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12631 Fremont Ave #5, Zimmerman, MN 55398 Tel: 763.482.5167 knutsonchiro@gmail.com Today's Date:___/___/___Your Name:___Name you prefer to be called:___ Address: ___Apt#:___ City ___, St.___ Zip___
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Identify the specific needs of the individual requiring home care services
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Research and contact eligible home care service providers
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Discuss and evaluate the available services, costs, and schedules
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Fill out the necessary paperwork and forms accurately
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Review and sign the contract agreement with the selected home care provider

Who needs select home care services?

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Individuals who require assistance with daily living activities due to aging, illness, disability, or injury
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Patients recovering from surgery or medical procedures who need additional support at home
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Family members who are unable to provide full-time care for their loved ones and need professional assistance
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Select home care services refer to a range of non-medical services provided to individuals who need assistance with activities of daily living in their own homes.
Providers or agencies that offer select home care services are required to file.
Select home care services can be filled out by providing information such as the type of services offered, the number of clients served, and any other relevant details.
The purpose of select home care services is to support individuals in maintaining their independence and quality of life while receiving assistance with daily tasks.
Information such as the types of services provided, number of clients served, hours of care provided, and any other relevant data must be reported on select home care services.
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