Release of Responsibility for Leave of Absence

Form Template

The Release of Responsibility for Leave of Absence mobile app allows long-term nursing facilities to sign out patients who are taking a leave of absence, while releasing the residential care facility, assisted living facility or nursing home from liability while the patient is away.

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The care facility resident leave form can be customized for any type of assisted living or residential care facility.

The release of responsibility form ensures that the assisted living facility or other long term care center isn't responsible for providing medical services while the patient is outside of the facility. Once the form has been read, the patient and care representative can sign off on the information electronically.

  • Signature Capture
  • Submission Editing
  • Reference Data
  • Dispatch
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  • iPhone
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  • Android
  • Windows
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  • Quickbooks
  • Salesforce
  • Google Docs
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