Serving Nevada and Placer Counties

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Forms for Caregivers

  1. Caregiver’s Profile/Application: The assessment tool which AMAH's Hearts uses to best determine your care qualifications and desires for a client. It is very comprehensive and gives us a great overview of your qualifications, experience, and skills.

  2. Agency Master Placement Agreement: The agreement that lists all the terms and conditions of being a part of the AMAH HomeCare Network.

  3. Shout-Out: The form AMAH's uses to contact you to let you know about a client in our network whose needs match your qualifications, based on your profile.

  4. Request For Proposal (RFP): The form used by the caregivers who have met the client’s terms of care and are selected to contact the client for an interview. The criteria for choosing which caregivers will be issued an RFP is based on the following: a) Qualifications/Experience, b) Shift Availability, c) Location. Generally, caregivers are selected on a first-come, first-served basis. It is highly recommended that you check your email frequently and respond immediately if interested.

  5. Caregiver’s Service Agreement: The agreement you sign that places you with a specific client. It lists the scope of your work and the terms and conditions we all agree to abide by.

  6. Addendum to CSA: An example of the formal addendum to any client service agreement that changes anything within that initial agreement. It may be based on the 30 Day Needs Assessment , or the wishes of the client.

  7. Daily charting is done one, possibly two, ways depending on what type of job-site you are on. The first way will always be by logging into the Clear Care's telephony system ( at the beginning and ending of each of your shifts. By responding to the prompts, a "care log" is generated that is automatically viewable by the office and the client's family, 24/7. For those job-sites that have multiple shifts and caregivers, there will most likely be an onsite binder where you will find "Charting sheets" you'll need to fill out for the oncoming caregiver to review. 

  8. Invoice: (downloadable/revisable/printable) You will submit your own invoice to AMAH’s office every Monday, by 4 PM. Invoices are NEVER to be given to any client. You can also submit invoices that have been generated from a bookkeeping software program (Quickbooks, etc.) as long as they state the exact date and times of service, and the dollar amount to be compensated for each shift worked.

  9. Needs Assessment: The form used to re-assess the client’s care needs. This is done by AMAH personnel.
Click here to apply!

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