Forms
AFHNA is providing the forms below for your use.
Disclaimer
AFHNA accepts no liability for the content of the forms provided or for any actions taken on the basis of the information provided. These forms are intended as samples only. Please review and modify the forms to reflect the needs of your residents. AFH providers are responsible for providing resident care according to State and Federal laws.
COVID-19 Related Forms
Administrative Forms
Dementia/Behavioral Related Forms
- Behavior Monitor Flowsheet
- Behavioral Approaches to Decrease Resistance to Bathing
- Caregiver Approaches to Decrease Resistive Behaviors in Residents
- Non-Verbal Cues for Pain and Anxiety Assessment Tool
- Managing Behavioral or Psychological Symptoms for People with Dementia (BPSD) Flowsheet
- BPSD Series Delirium and Medical Issues
- BPSD Series Non-Drug Approaches (ongoing)
- WHEN YOUR RESIDENT IS RESTLESS (Great poster for caregivers!)
- Night Activity Form
Diabetes Care in the Adult Family Home
Labor and Industry Compliance
- Bloodborne Pathogen Certificate Sample
- Bloodborne Pathogens 2019 Video File not found in AFHNA Website Documents.
- Hepatitis B Vaccination Form
- L & I Safety Orientation Checklist
- Emergency and First Aid Checklist
- Sharps Injury Log
Medication Related Forms
(for insulin related forms see Diabetes Care in the Adult Family Home above)