Adult Day Care Assessment/Service Plan/ Plan of Care
Adult Day Care Assessment/Service Plan/Plan of Care
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Signature Record
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Note: An individual’s signature indicates their personal participation in the assessment process and approval of the plan.
THE DEPARTMENT OF HEALTH AND MENTAL HYGIENE HAS NOT CREATED AN ELECTRONIC SIGNATURE POLICY. THIS PAGE MUST BE PRINTED AND SIGNED BY EACH INDIVIDUAL WHO PARTICIPATED IN THE PROCESS.
Rev: February 2012
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