SAMPLE AFH NEGOTIATED CARE PLAN - Wa

All example text in this sample is provide for illustrative purposes only and should not be depended on to develop Negotiated Care Plans for your residents. RESIDENT. NAME. PROVIDER NAME . CURRENT DATE. DATE ENTERED. DATE DISCHARGED. DATE OF BIRTH. AGE. SSN. PRIMARY LANGUAGE. NAME & ADDRESS OF INTERESTED PARTY (GUARDIAN, POA, FAMILY) HOME PHONE ... ................
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