Free Forms to Improve Your Employee Files

Chamberlin & Reinheimer works with hundreds of specialized businesses just like yours. We have crafted the following editable forms for your office to help make sure your policies and procedures are in place AND signed before a claim. Taking the time to make sure every part of your business is protected can make your position as strong as possible when a claim arises. You are only as good as your employee file and the following items are provided to our clients for FREE to help your business.

Each file that is provided is editable in Word allowing you to put your logo, colors and customize questions if needed for your specific business. Taking the time to do things right will strengthen your business for any claims. With Chamberlin & Reinheimer by your side, know that we have your best interest in mind and will continue to provide the latest materials to help you succeed.

CHAMBERLIN & REINHEIMER INSURERS, INC

POLICY AND PROCEDURES PROVIDED TO CLIENTS

ALL ARE EDITABLE

Sample MVR Release Form – This is an authorization release for the employed Caregiver to give you permission to run their Motor Vehicle Report

Sample Cell Phone Policy – Details allowed usage of a cell phone while driving on company time

Personal Vehicle Hired Non-Owned Driving Policy – Detailed driving policies and what to do when a caregiver is involved in an accident using their personal vehicle for work

Sample Sexual Abuse Policy – What to look for and what to do when abuse is suspected in the Home by the caregiver

Client Theft of Property Policy – Company policy signed by caregiver on how valuables are to be handled within the client's home / facility

Formalized return to work program for Light Duty – This provides job descriptions that can be given to an injured employee when on Workers Compensation.

Sample How to Help Someone Who Uses a Wheelchair – How to Transfer someone in a Wheelchair

Sample Gait Belt Procedures – How to use a gait belt properly

Sample Client Permission Car Release Form – This form is used when a Client asks the Caregiver to drive their car

Sample Client Home Evaluation Checklist – This form is for the case manager to use in evaluating the physical hazards of the Home that the Caregiver will be going into

Sample Drug Testing Acknowledgment Form – This is a sample policy for Drugs and Alcohol for the Home Care / Home Health Agency

Bicycle Safety Agreement – For agencies in urban environments – if Caregivers are using a bike to travel to client's homes

Credit Card Debit Card Usage Form – This is required to be filled out by the caregiver anytime purchases are made on behalf of the client

Customizable Lift Policy – A Client Patient Transfer Policy and Procedures

Dog Attack Dangers – Describes the dangers of dogs and the cost of Bites for Workers Compensation Claims

Medical Waiver Form – Form used when a caregiver refuses treatment for a work injury

Sample Physical Exam Form – This form is signed by the Primary Care Physician on caregivers' physical abilities to do their job

Walking Safety Agreement – For Agencies that are in Urban areas where Caregivers walk to see Clients / Patients

Onsite Drug Testing – We have a relationship with an on-site drug testing kit provider. Pricing was $2.65 per test at last update and is subject to change; contact us for current pricing.