AFC Sample Starter Packet - State of Michigan - mich 2025

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  1. Click ‘Get Form’ to open the AFC Sample Starter Packet in the editor.
  2. Begin by entering the resident's name and date of birth in the designated fields. Ensure that all information is printed clearly for accuracy.
  3. Proceed to the Social/Behavioral Assessment section. For each item listed, check 'Yes' or 'No' and provide detailed descriptions where necessary, especially if any needs are identified.
  4. Continue to the Self Care Skill Assessment. Again, indicate whether assistance is needed for each task and describe how those needs will be met.
  5. Fill out the Health Care Assessment by checking 'Yes' or 'No' for medication needs and special diets, providing additional details as required.
  6. Complete the Medical Information section with your primary physician's details and any medications currently taken.
  7. Finally, ensure all signatures are obtained in the Signatures section before saving your completed form.

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