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1. Parties: Identification of all parties involved - care recipient, legal representative (if applicable), caregiver, and caregiving agency (if applicable)
2. Background: Brief context explaining the need for caregiving services and the purpose of the consent form
3. Definitions: Clear definitions of key terms used throughout the document including 'caregiving services', 'emergency', 'medical intervention', etc.
4. Scope of Care: Detailed description of caregiving services to be provided, including daily tasks, medical assistance, and limitations
5. Medical Authorization: Specific permissions granted to the caregiver regarding medical decisions and emergency response
6. Confidentiality and Privacy: Obligations regarding personal and medical information protection in compliance with PDPA 2010
7. Emergency Procedures: Protocol for emergency situations, including contact hierarchy and decision-making authority
8. Liability and Indemnification: Clear statement of liability limitations and indemnification provisions
9. Duration and Termination: Period of validity for the consent and conditions for termination
10. Execution: Signature blocks for all parties and witnesses
1. Special Medical Conditions: Detailed section for cases where the care recipient has specific medical conditions requiring specialized care
2. Medication Management: Section detailing medication administration authority and procedures when medication management is part of care duties
3. Transportation Consent: Additional permissions for caregivers who need to transport care recipients
4. Religious or Cultural Preferences: Special instructions regarding religious or cultural practices that must be observed during care
5. Alternative Decision Makers: Section appointing alternative decision-makers when primary contact is unavailable
6. Financial Authority: Optional section granting specific financial management permissions if required
1. Schedule A - Care Plan: Detailed daily care plan including specific tasks, timing, and special instructions
2. Schedule B - Medical History: Summary of relevant medical history, current conditions, and medications
3. Schedule C - Emergency Contacts: Comprehensive list of emergency contacts in order of priority
4. Schedule D - Medication Schedule: Detailed medication list with dosages and administration times if applicable
5. Appendix 1 - Medical Power of Attorney: Copy of existing Medical Power of Attorney if applicable
6. Appendix 2 - Identification Documents: Copies of relevant identification documents for all parties
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