№ files_lp_3_process_7_042623
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Administrative social services intake record used by the Area Agency on Aging of North Central Texas to collect identification, demographic, income, service request, and relationship information for caregivers and care recipients in January 2024.
Year:
2024
Month:
January
Region:
North Central Texas
Organization:
Area Agency on Aging of North Central Texas
Document Type:
Administrative intake form
Form Number:
2270
Subject:
Caregiver and care recipient identification and service request
Confidentiality:
Information is confidential and shared only to initiate or modify services
Related Guidelines:
2024 Department of Health and Human Services Federal Poverty Guidelines
Target Population:
Caregivers aged 18 or older; caregivers aged 55 or older for specific categories; care recipients aged 60 or older, minors, or adults with disabilities
Services Listed:
Benefits Counseling; Caregiver Education; Emergency Response System; Health Maintenance Supplies; Home-Delivered Meals; Medication Management; Nutritional Supplements; Personal Care; Prescription Assistance; Residential Repair; Respite; Transportation; Utility Assistance
Geographic Scope:
Counties within North Central Texas
Price: 8 / 10 USD
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The product description is provided for reference. Actual content and formatting may differ slightly.
Year:
2013
Term:
Spring
Course code:
History 2270
Instructor:
Prof. Stephen Kern
Location:
Cockins 218, The Ohio State University
Meeting times:
WF 9:35-10:55
Office hours:
Tu, Wed 11:00-11:30 or by appointment
Contact:
[email protected]
Note:
, 292-7308
Required texts:
Charlotte Brontë, Jane Eyre; D. H. Lawrence, Women in Love; Carol Shields, The Republic of Love; Diana Hacker, A Pocket Style Manual
Recommended texts:
Simone de Beauvoir, The Second Sex; Stephen Kern, The Culture of Love: Victorians to Moderns
Assignments:
Three papers (4 pages each), class participation
Grading:
Paper 1 30%, Paper 2 30%, Paper 3 30%, Participation 10%
Course focus:
Historical and literary analysis of love from 1800 to present
Audience:
Undergraduate students in history
Special accommodations:
Office for Disability Services, 150 Pomerene Hall, 292-3307, TDD 292-0901
Academic integrity:
Committee on Academic Misconduct, Faculty Rule 3335-5-487
Course objectives:
Historical perspective, analysis of primary sources, critical writing and discussion
Program:
Caregiver Support Program (CSP)
Document type:
Installation guide
Release:
PXRM2.037
Publication date:
October 2015
Organization:
U.S. Department of Veterans Affairs, Veterans Health Administration
System:
CPRS and TIU
Subject area:
Clinical reminders and interdisciplinary notes
Audience:
Caregiver Support Coordinators and clinical staff
Number of reminder dialogs:
Eight
Related standards:
VHA Enterprise Standard Title “CAREGIVER CERTIFICATE”
Implementation context:
Parent and child interdisciplinary notes
Year:
2018
Region / City:
Arizona
Topic:
Child Safety, Foster Care
Document Type:
Form
Institution:
Arizona Department of Child Safety
Author:
Arizona Department of Child Safety
Target Audience:
Kinship foster caregivers
Effective Period:
Ongoing
Approval Date:
Not specified
Amendment Date:
Not specified
Year:
Not specified
Region / City:
Not specified
Theme:
Legal planning, estate planning, healthcare directives
Document Type:
Informational brochure
Organization:
Preferred Legal Plan
Author:
Not specified
Target Audience:
Caregivers, individuals preparing for potential incapacitation
Period of Validity:
Not specified
Approval Date:
Not specified
Modification Date:
Not specified
Year:
2000
Region/City:
Washington State
Topic:
Family Caregiver Support
Document Type:
Policy and Procedure Manual
Organization:
Area Agency on Aging
Author:
Dana Allard-Webb
Target Audience:
Family caregivers, Area Agency on Aging staff
Effective Period:
Ongoing
Approval Date:
2000
Revision Date:
2007
Note:
Year
Note:
Year
Topic:
Caregiver Support
Document Type:
User Guide
Organization:
Instant Care
Target Audience:
Caregivers
Year:
1980–1998
Type:
Questionnaires / Inventories
Subjects:
Depression, Anxiety, Epilepsy, Stigma, Adverse Effects of AEDs, Caregiver Burden
Instruments:
Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), QOLIE-31, Liverpool Stigma Scale, Liverpool Adverse Events Profile (LAEP), Zarit Caregiver Burden Inventory (ZCBI)
Authors:
Beck, Cramer, Jacoby, Baker, Zarit et al.
Population:
Patients with epilepsy and their caregivers
Scoring:
Various Likert scales and total scores indicating severity or burden
Note:
Year
Contextual description of the document:
Timeline for data collection for caregivers and children in a health and wellness program, outlining forms to be completed during different enrollment and age milestones.
Year:
2026
Region/City:
Not specified
Topic:
Transportation reimbursement for caregivers
Document type:
Policy
Organization:
DCYF
Author:
Not specified
Target audience:
Caregivers, caseworkers
Effective period:
Not specified
Approval date:
Not specified
Modification date:
Not specified
Year:
2013
Region / City:
New York, NY
Topic:
Mentoring Programs
Document Type:
Survey
Organization:
Public/Private Ventures
Author:
Herrera, C., DuBois, D. L., Grossman, J. B.
Target Audience:
Caregivers/Parents of Youth in Mentoring Programs
Period of Validity:
Not specified
Approval Date:
Not specified
Date of Changes:
Not specified
Document Type:
Caregiver Agreement Form
Program:
Enhanced Foster Care (EFC)
Service Type:
Family-Based Foster Care Treatment Service
Related System:
MiSACWIS
Subject:
Child Eligibility for Enhanced Foster Care Services
Participants:
Identified Caregiver(s), Assigned Foster Care Agency, EFC Clinical Case Manager, EFC Supervisor, PAFC Director
Required Information:
Child Name, Date of Birth, MiSACWIS Person ID, Caseworker, Foster Parent Name and Address
Content Elements:
Caregiver Qualifications, Completed Training, Scheduled Training, Transition Plan, Behavior Management Techniques, Service Level Engagement, Educational Participation, Crisis Management Tasks
Compensation Basis:
Daily Rate Above Standard Determination of Care
Rate Levels:
Level I, Level II, Level III, Adapted Rate
Signatures Required:
EFC Clinical Case Manager, Caregiver(s), EFC Supervisor, PAFC Director (if waiver required)
Waiver Condition:
Exception Authorization or Confirmation of Pressley Ridge Treatment Parenting Model Completion
Target Population:
Children in General Foster Care with Intensive Behavioral or Emotional Needs
Note:
Year
Topic:
Duchenne muscular dystrophy, caregiving
Document Type:
Questionnaire
Target Audience:
Caregivers of children with Duchenne muscular dystrophy
Jurisdiction:
New Zealand
Legislation Referenced:
Education (Pastoral Care of Tertiary and International Learners) Code of Practice 2021
Relevant Clauses:
53 and 76
Regulatory Authority:
NZQA
Document Type:
Application Form
Purpose:
Assessment and approval of residential caregivers for international learners
Intended Applicants:
Homestay carers, designated caregivers, temporary accommodation supervisors
Issuing Body:
[Name of Education Provider]
Subject:
Residential care arrangements for international learners
Key Requirements:
Safety check and police vetting for household members aged 18 and over
Information Collected:
Personal details, household composition, medical information, accommodation details, learner arrangements, referees
Declaration:
Applicant confirmation of accuracy and completeness of information
Approval Requirement:
Governing board approval and independent legal advice recommended prior to use
Year:
2026
Region / City:
United States
Subject:
Child welfare survey participation
Document type:
Lead letters and fact sheets
Organization / Institution:
Administration for Children and Families; RTI International; University of North Carolina at Chapel Hill; Washington University in St. Louis
Author:
Christine Fortunato, Ph.D.
Target audience:
Caregivers, legal guardians, emancipated youth, young adults
Survey period:
12-month selection period
Incentives:
Monetary compensation and gift certificates for child participants
Methodology:
In-person interviews and caseworker data collection
Confidentiality:
Participant information kept private as permitted by law
OMB Control Number:
0970-0202
Note:
Year
Topic:
Medicaid Services, People with Disabilities, Case Management
Document Type:
Guide
Organization / Institution:
Oregon Department of Human Services (ODHS)
Target Audience:
Case Managers, Social Workers, Healthcare Providers
Note:
Year
Year:
2025
Region / City:
Kampala, Uganda
Subject:
Education, Humanities and Social Sciences
Document Type:
Application Form
Institution:
Makerere University
Author:
Makerere University
Target Audience:
Prospective PhD students
Period of Validity:
2026 Intake
Approval Date:
November 17, 2025
Date of Revision:
N/A
Note:
Year
Region / City:
Arkansas, USA
Type of Document:
Intake Form
Institution:
Arkansas Adult Education
Target Audience:
Adult learners
Required Fields:
Personal information, program selection, employment status, contact details
Program Categories:
Adult Education – ABE, Family Literacy, Workplace Literacy, ESL
Disability Status:
Optional disclosure
Military Service Information:
Optional disclosure
Data Sharing Agreement:
Required for participation
Emergency Contact:
Required
Social Security Requirement:
Not mandatory for participation
Enrollment Programs:
WIOA Core Programs, Title 1, Title 3, Title 4