Appendix 35 Negotiated Risk Agreement Form 2025

1. Click ‘Get Form’ to open the Appendix 35 Negotiated Risk Agreement Form in the editor.
2. Begin by entering the participant's last name, first name, and middle initial in the designated fields. This information is crucial for identifying the individual involved.
3. Input the MSSP number in the appropriate field to ensure proper tracking and management of the agreement.
4. In the section labeled 'Participant’s desire/preference', clearly articulate what the participant wishes regarding their care and risk management.
5. Describe the current situation and any causes of concern in detail. This helps all parties understand the context of the agreement.
6. Outline possible or probable negative consequences that may arise if risks are not managed effectively.
7. List possible alternatives to minimize risk, providing options for consideration by all parties involved.
8. Document any final agreements reached by all parties in the designated area, ensuring clarity on commitments made.
9. Specify how frequently reassessment of risk will occur, which is vital for ongoing management and support.
10. Finally, ensure that both the participant and care manager sign and date the form to validate the agreement.

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