Member Corner

• Policies and Procedures
• Employment Policy
• New Hire Package
• Biweekly Time Sheet
• Employee Direct Deposit Authorization
• W-9 form
• W-4 form
• New Intake of Data Package and Medical Emergency
• Form 22776 – Client Intake and Service Request
• Form 3751 – A Nurse Assesment
• Waiver of Liability
• Consent for Treatment
• Consent for photograph
• Application for Services
• Notice of Advance Directive
• Statement of Client Right
• New Client File Folder
• Client File
• Daily Transportation Record
• Daily Attendance Record
• Individual TB Screening
• Physician’s Orders
• Health Assessment & Individual Service Plan
• Utilization Review Report
• Notification of Critical Omission
• DADS Direct Deposit Authorization
• Attendant Work Sheet Instructions
• DAHS Workshet
• Instructions to complete DADS Cost Report
• ADC Daily Meal Count & Attendance Record
• ADC Daily Menu Record
• ADC Enrollment Form
• ADC Form 4502
• ADC Meal Benefit Income Eligibility Form
• ADC Time Distributing Report
• ADC Training & Activity Report
• Daily Meals Production Record
• Documentation of Meals Served
• Food & Nutrition Complaint Form
• Letter of Determination
• Fire Drill Report
• DAHS Contract Monitoring Workbook
• Form 2059 – Summary of Client Need for Services
• Form 2060 – Need Assessment Questionnaire
• Form 2067 – Case Information
• Form 2101 – Authorization for Community Care Services
• Texas Department of Human Services
• Application of Employment for Lido
• Form 3050 Health Assessment Individual Service Plan
• Form 3055 Physicians Orders
• Meal BIE Form
• Medication List
• Monthly Assessment Form
• Vitals Signs Sheet
• How to file a Complaint