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The enrollment package includes an:

  • Application for Sliding Scale Fee - We offer services on a sliding scale fee  This form is used to determine eligibility 
  • 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.
  • Food Program Eligibility - Food Program income eligibility application
  • Policies and Admissions Agreement - Describes the types of services that our facility will offer and the policies of the agency. 
  • 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.
  • Items to Bring - Items to bring with the participant on the first day
  • Photo-Voice Release - gives the center the right to use photos or voice recordings of participants


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