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Representative Name (if exists): Participant Name:DIRECT SERVICE WORKER DATA FORM Assistance with the hiring process: If you need assistance completing this packet, please call the Consumer Direct
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How to fill out direct service worker contact

01
First, gather all necessary information such as the direct service worker's name, contact information, availability, and any specific skills or qualifications required.
02
Next, fill out the contact form or document provided by the agency or organization employing the direct service worker.
03
Ensure all information is accurate and complete before submitting the form or document.

Who needs direct service worker contact?

01
Individuals or families seeking assistance with personal care, household tasks, or other services may need to contact a direct service worker.
02
Organizations or agencies that provide support services may also need to maintain contact information for direct service workers.
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Direct service worker contact refers to interactions between direct service workers and clients or patients.
Employers are required to file direct service worker contact for each employee who has direct contact with clients or patients.
Direct service worker contact can be filled out electronically or on paper by providing basic information about the employee and the nature of their contact with clients or patients.
The purpose of direct service worker contact is to track and monitor interactions between employees and clients to ensure quality care and safety.
Information such as employee name, contact information, job title, type of contact with clients, and any training or certifications must be reported on direct service worker contact.
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