I acknowledge that I have been trained on and received and read a copy of the following Hospice Care of Southwest Michigan’s policies pertaining to Abuse Prevention/Reporting:

·        Adult/Child Abuse Prevention & Reporting (Employee Manual)

·        Assessment of Suspected Adult Abuse/Neglect/Exploitation (Procedures Manual)

·        Assessment of Suspected Child Abuse/Neglect/Exploitation (Procedures Manual)    

Additionally, I understand that:

·        All Agency clients, families, employees, volunteers or others have a right to reside or work in an environment that is free from abuse;

·        As an Agency employee I have the responsibility not to engage in behaviors that constitute abuse towards another individual;

·        In addition, I have the responsibility to report any suspected or alleged instances of abuse to the appropriate personnel.

·        I agree to abide to by all aspects of the above mentioned policies and revisions to these policies going forward.


I also understand that if I have any questions concerning the information contained in these policies or the training received on these policies, I will follow up with my supervisor or any other member of management.