• Intake with Angels Service LLC:)Thank you for being part of our community. 

    *A Comprehensive review and medical form may be required to initiate services. Please make sure we have all relevant information to provide care in a safe and comprehensive manner.
  • Objective of this agreement: We wish to establish a successful long term therapeutic relationship and want everyone to understand the system we work in and the rules and regulations that govern our services, as well as internal policies and procedures. 

    By initiating services with Angels Service LLC and any contractors of Angels Service LLC you agree and consent to all current rules & regulations and policies & procedures. Current information can be found on http://www.watchingfish.com/the-legal-stuff

     

  • Client Information

  • Communication via text messages or other similar platforms such as social media, are not HIPAA compliant. I understand that if I choose to use these methods of communication, I am waiving my right to HIPAA in those instances.

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  • Click for more information regarding advance care planning for individuals and families.

     

    Information found here:

    What is advance care planning?

    What is an advance directive?

    Why do I need an advance directive?

    What advance directive is right for me?

    What should I do right now?

    Tools available for indivdiuals and caregivers (also available in Spanish)

  • Waivers and Agreements

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  • Client Details

  • If a section does not apply to you, write none or NA

  • Agreement and Consent Highlights

  • 90 Day Reviews

    As a mother to a child the founder of this agency is well versed in quarterly meetings with case managers, 60 day recerts for nursing and other professional services. In order to align with best practice monitoring we to do reviews on a regular basis. Once a year we need would like to see you, this may be in person or through a video chat, which ever works best for you. HOWEVER, IF THE SERVICE IS COMPREHENSIVE VISITS ARE EVERY 1 to 3 MONTHs OR IF THEY ARE HANDS ON SERVICES THEN EVERY THREE MONTHS.Throughout the year we will do result monitoring by reviewing notes, reaching out to you, or talking to your providers. Please feel free and encouraged to reach out whenever you like.
  • Updates

    If you have praise, concerns, or updates regarding medications, scheduling, needs, etc. Please visit our website www.watchingfish.com and see the bottom of the page and find the section that says "I'm a Family Member or Client" There will be forms for updating your information, concerns, praise, etc. or call 720-256-8875To file a complaint with the state: Call 303-692-2910 It is highly recommended in the case of a concern to start with the main number for the agency so that we can complete the grievance and compliant procedure in order to come to a resolution. IF WE DO NOT HEAR FROM YOU OR YOU DO NOT RESPOND TO OUR REQUEST FOR AN UPDATE WE WILL ASSUME THAT ALL IS WELL WITH SERVICES AND LIFE IN GENERAL, SO PLEASE IF YOU NEED ANYTHING, LET US KNOW.
  • I understand that if anything changes with the waiver funding services or any other aspect of the client profile (needs, wants, diagnoses, medications, surgeries, etc.) I must directly update AngelsServiceLLC@gmail.com in order to make sure care is provided in the best way possible.

  • Required Release of Information

  • I understand that to receive services, it is an inter-agency collaboration and that information about my child and family will be shared between needed agencies for
    support, planning, and developmental. This includes my local Community Center Board, State agencies, Contractors, and Inter-Disciplinarian team members.

    I hereby authorize the mutual exchange of information regarding the named person and the agencies / individuals listed on this form. INCLUDING, NOTES, CLIENT DETAILS, PHOTOS, VIDEOS, OTHER WORK SAMPLES, AND PROFESSIONAL OPINIONS.

    There is a focus on trans-disciplinarian teamwork, this means that professional from different backgrounds will discuss different details and strategies to improve services.

    I have been fully informed of the intended use of this information sharing. I also understand that the agency / person receiving this information is obliged to maintain it in a confidential manner and it is to be used only for the purpose I have authorized. I understand that this information will be kept in a database that is password protected,and for the exclusive goal of optimizing communication, resources, and supports for (myself, child, and / or family).

  • Some services, such as massage therapy or certain skills acquisition or replacement programs may include specific restrictive practices in order to meet the goal. This falls outside of the restraint procedures.

    *For example, range of motion, stretching, bolstering, and positioning in massage therapy may be restrictive.
    *For example, hand over hand work to help with skill acquisition may interrupt a client's preferred movement pattern or activity.

  • Rights, Consent, Expectations and Discontinuation

  • It is my right as the client / family member, and my responsibility, to communicate with the agency and provider.

    If I have specific techniques or programming that I would like to see I will share this with the agency so that it can be part of the plan.

    Clients and families receive the most benefit when they:
    · Participate in activities, ask questions and communicate openly with the provider
    · Create the most comfortable environment for themselves during service time possible
    · Explore recommendations and offer feedback/comments to provider at next visit
    · Be alert, well rested, etc. to the best of ability

    Call service coordinator to assist with finding support groups, resources and billing questions.

    For Massage:
    • Create the most relaxing environment for themselves based off of their personal preferences.

    o Some prefer music, some prefer silence, books on tape, tv, etc
    o Some want a massage that is integrated into daily living some want a spa like
    Experience or even incorporate play into the massage session
    o Oil, lotion, or dry, scents, etc.

  • Timeliness is important and we strive to begin sessions at their scheduled time but due to driving between homes and uncontrolled circumstances start time may vary 10-15 minutes at times.

    If your service is time sensitive, such as the provider is the only one caring for a client after school or another caretaker will not be available to provide care, make this known so that providers can arrange schedules to accommodate the time sensitive nature of the appointment.

    If at any time your provider is not providing the agreed upon service within your expected timeline, reach out an alert us directly.

    · Safety is our #1 concern. Home visits may be cancelled if road conditions are poor and there are travel advisories.

    -Caregivers must be present for the entire visit for early intervention.
    -Other services and individualized service plans may or may not require caregiver presence during sessions.

    · Please call the provider to cancel appointments. Sessions may not be able to be rescheduled. If there is less than 3 hours notice, a care conference may need to conducted. If client's do not regularly keep their appointments service may not be able to continue.

    · Please note that frequency of visits may be reduced or change during holidays, vacation times, or due to a provider becoming ill. If the provider cancels the care-giving responsibility reverts to the primary caretaker unless other plans are specifically made.

    · If a family is not home for a scheduled visits, does not return phone calls or other attempts to contact them, it is assumed the family does not want to participate in services and will be discharged. This will be documented and the case manager updated.

    · If individual has aggressive challenges caretaker must be close at hand during sessions and is responsible for intervening and any damages unless otherwise planned for.

    *Requests for schedule changes will try and be accommodated but will depend if the provider has openings.

  • If you are receiving Early intervention services they end at the child's 3rd birthday / family discontinues services / services is no longer needed / funding is not available.

    If you wish to discontinue services you may do so at anytime. Please let us know.

    If your provider become unavailable outside of basic illness or vacation we will reach out to you to discuss options such as another provider with our agency if possible or contacting your case manager for a referral. Depending on your service type, we may also contact CDHPE at the state to inform them that we cannot provide services.

    If due to actions from the client or family that jeopardizes the well-being of a provider an emergency discharge will take place and case management and CDHPE will be notified within 48 hours.

  • Pay

  • Client or responsible agent is responsible for payment if insurance does not reimburse services. (Does not apply to Medicaid clients when the service is a covered service in detail, frequency, and duration).

  • Paperless Company

  • If you would like a copy of any policies and procedures please request them in writing. Otherwise, we are a paperless company and all policies and procedures are found on our website.

    http://www.watchingfish.com/expectations This is our policy and procedure manual. There are also many other resources.

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  • Need Rating

    We are unable to serve critical care clients and if this is your need would like to help you find an agency with the skill set you need.
  • Safety Plan

    In case something happens when we are at your home. :)
  • Signatures

  • Clear
  • Signatures for the State Mandated Forms and Intake

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  • Revisions:

    6.28.22 Removed questions about requesting more information about advanced directivites. Add in link and headlines for CDHPE advanced directive information

  • Should be Empty: