Resident Forms

AFC History & Physical Exam Form (71980-49 3/13) (Word) (PDF)
AFC Incident Report (71980-62a 5/10) (Word) (PDF)
AFC Medical-Dental Visit Order Form (71980-96 [P] 11/10) (Word) (PDF)
AFC Mobility Access Assessments (71980-233 5/16) (Word) (PDF)
AFC Resident Info (71980-36 7/16) (Word) (PDF)
AFC Resident Rights (DHS 8/18) (Word) (PDF)
Consent to Share a Bedroom with a Particular Person (71980-57 4/12) (Word) (PDF)
Individual Abuse Prevention Plan-IAPP
(DHS-16-180924 8/18) (Word) (PDF)
Individual Resident Placement Agreement
(71980-37 4/12) (Word) (PDF)
Permission for AFC Provider to Administer Medications (71980-52 4/12) (Word) (PDF)Physician's Statement for Medication Administration (71980-220 3/13) (Word) (PDF) Resident Monthly Cash Record (71980-27 11/10) (Word) (PDF)
Vulnerable Adults Act Summary (DHS-306117 8/18) (PDF)

These forms can be used as an index to the file.
Financial Records
Medical Records
Posted Records
Provider Records
Resident Records