Wendy Taylor, MSW

(707) 824-5637

Taylor Elder Care Management, Sebastopol CA. Wendy Taylor's qualifications include 30 years as a social worker specializing in medical and mental health care, 21 years of experience as a geriatric social worker providing case management and 14 years of experience as a social work mental health case manager.

Taylor Elder Care Management
Agreement FOR PAYMENT

Please fill out the and submit the form below.

AGREEMENT FOR PAYMENT TO TAYLOR ELDER CARE MANAGEMENT

Today's Date

Date of Agreement

YYYY

This Agreement made between Taylor Elder Care Management (TECM) and:

And is for the terms of payment to Taylor Elder Care Management for care management consultation provided by TECM to client.

By submitting this form, Client agrees to pay TECM at the rate of $150.00 per hour for Consultation rendered. Drive time for TECM is also charged at the rate of $150.00 per hour.

TECM will provide weekly Invoice to Client or Client’s Representative, as applicable for Care Management Consultation Services rendered. Client or when applicable, Client’s Representative, agrees to pay for such services within 15 (fifteen) calendar days of the date of such Invoice.

TECM agrees to provide care management services according to our professional standards as follows: Initial assessment of client's care needs, safety issues, and medical and mental health status. Ongoing recommendations to responsible party for services such as hired attendant care, evaluations by specialists, communication with physician and health care systems, day treatment programs or other psycho-social services. Regular communication with family and weekly visits (or less when appropriate) for monitoring of care management plan in place. Recommendations for adjustments to care plan if client's needs increase.

A copy of TECM notes for documentation of TECM’s time spent will be provided client upon request at the rate of $150.00 per hour This agreement may be terminated by Client or TECM at any time by oral or written notice.

By submitting this form, Client agrees to pay TECM at the rate of $150.00 per hour for Consultation rendered. Drive time for TECM is also charged at the rate of $150.00 per hour.

I Agree

I Do Not Agree

Taylor Elder Care Management Agreement FOR PAYMENT

Please fill out the and submit the form below.

Your information will be kept confidential and private. Questions? Email: support@tayloreldercare.com (click here) or phone: (707) 824-5637

Taylor Elder Care Management
Agreement FOR PAYMENT