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The enrollment package includes an:

  • Intake Form - includes basic information about the client, such as: wandering, bathroom needs, diet, medications, ambulation avility, anxiety, typical reactions to a new place, likes, dislikes, spouse and children's names, where they live and have lived, and previous occupations and interests. This information is read by all staff before the client has their first official day at the center. Using names and places with which the client is familiar, helps the staff to ease anxiety, and it reassures the client they are safe and are only here for a visit.
  • Registration Form - gives the address of the client, caregiver's phone numbers, people allowed to pick up the client here at the facility, and the client's doctors names and phone numbers.
  • Medical History Form - is to be filled out by the client's physician. This form may be given to the family or FAXed directly to the physician's office.
  • Medications Form - is filled out and any medications to be administered at the center are discussed with the nurse. Medications are required to be in duplicate prescription bottles and may be brought to the center daily or a supply left at the center. It is the family's responsibility to notify the nurses of any medication changes.
  • Release Form - which gives the center permission to take a client's pictures and use them in different promotions for ALPS, is discussed with the family. The family decides whether or not they do or do not want their loved one to be photographed.
  • Waiver of Liability Form - is required to be signed.
  • Activities of Daily Living Check List - is completed by the family to give us a basic idea of what the client can do for themselves or where they require assistance.
  • DNR (Do Not Resuscitate) Form - is offered, should the client decide to enforce DNR rights, a copy of the DNR order is obtained. All of these papers are kept in the client's personal chart.



ALPS Adult Day Care Center
600 N. Daisy Street
Morristown, TN 37814
(423)587-9149
Fax: (423)587-9234