BCAL-3266: Michigan AFC Resident Care Agreement

Form BCAL-3266 PDF Details

This agreement is to be completed by the licensee in cooperation with the resident or his/her designated representative and the responsible agency, if applicable.

Authority: If a resident's designated representative signs this agreement, a copy of the signer's written authority is to be maintained in the resident's file.

Signatures: Resident, Resident's Designated Representative (if applicable), Licensee/Licensee Designee and Responsible Agency (if applicable), each with a Date.

Copy: A copy of this resident care agreement is required to be provided to the resident's guardian or resident's designated representative.

Complaints: Complaints (only) can also be made by calling toll-free: 1-866-856-0126.