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Assisted living disclosure statement

Form 3647-2025

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4.8 out of 5

130 votes

The Texas Department of Aging and Disability Services provides an Assisted Living Disclosure Statement to inform prospective residents and their families about facility policies and services. This document outlines the pre-admission, admission, discharge processes, care planning, aging in place policies, staff training, physical environment safety features, staffing patterns, and residents' rights. It aims to facilitate informed decision-making by offering a standardized format for comparing assisted living facilities.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the facility name, license number, and contact details in the designated fields at the top of the form.
In Section I, indicate any services not offered by your facility by checking the appropriate boxes. Provide details about your pre-admission process in Section I-B.
Fill out Section I-C with information on included services and amenities, specifying frequency where applicable.
Continue to Section II to outline your admission process, including necessary documentation and any special communication provisions.
Complete Sections III through X by checking relevant options and providing detailed responses regarding discharge policies, care planning, staff training, and residents' rights.

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Versions	Form popularity	Fillable & printable
2013	4.8 Satisfied (130 Votes)

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