Matching - User Agreements & Liability Releases

USER SERVICES User Agreements and Liability Releases Purpose of Policies Specific policies should be developed for the operation of an AT device re-use program. Written policies provide the basis for staff decision-making and minimize the possibility of arbitrary decision-making or discrimination in the provision of services. Documenting these policies and providing them to the prospective user provides needed information about eligibility and terms of use. These policies should cover: Eligibility conditions for acquisition of a device  Fees, if any Medical referral, if required Procedures Procedures specify the process by which devices can be acquired. They should include: An application process for the prospective user Medical (professional) prescription for the device, if required A staff procedure for matching needed device(s) to user Documentation of the assigned device for user file and inventory tracking Disclaimer of liability Documentation of payment User acceptance of responsibility for device Documentation of delivery/ receipt

See the attached documents for examples. Some documents are designed to serve multiple purposes.


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This work is supported under a five-year cooperative agreement # H235V060016 awarded by the U.S. Department of Education, Office of Special Education and Rehabilitative Services, and is administered by the Pass It On Center of the Georgia Department of Labor – Tools for Life.  However, the contents of this publication do not necessarily represent the policy or opinions of the Department of Education, or the Georgia Department of Labor, and you should not assume endorsements of this document by the Federal government or the Georgia Department of Labor.


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Title: Matching - User Agreements & Liability Releases
Module: User Services
Author: Trish Redmon
Audience: Administrator
Sub Title:
Organization Source: Pass It on Center
Last Reviewed: 01-23-2009 8:13 AM