Voluntary Discharge from Assisted Living In Colorado

Recent changes to assisted living regulations in Colorado have added requirements for involuntary discharge of residents. Creating a voluntary discharge form for a resident to depart from and end services at an assisted living residence in Colorado should include several key elements to help law enforcement, family members, and government officials understand the particulars of someone’s departure.

Law enforcement in particular may have some misplaced ideas about the freedom of movement of assisted living residents, and a voluntary discharge form eliminates uncertainty that can arise with a simple “sign-out” log.

Here are some ideas for what you might include in a voluntary discharge form:

Voluntary Discharge Form

Resident Information:

Full Name:

Date of Birth:

Current Address:

Room/Unit Number:

Discharge Details:

Planned Discharge Date:

Reason for Discharge:

New Address/Destination: (Really important!)

Acknowledgment of Discharge:

I, [Resident Name], understand that I am voluntarily choosing to leave [Facility Name] as of [Discharge Date]. I have discussed my discharge with the facility staff and understand the implications of my decision.

Health and Safety Considerations:

I confirm that my health and safety needs have been considered and addressed. Arrangements for continued medical services and transfer of medical records have been made as necessary.

Financial Arrangements:

Final billing and payment process has been discussed. Any refunds or remaining balances will be handled according to facility policy. Instructions on handling personal belongings have been provided.

Signatures:

Resident/Legal Representative:

Date:

Witness:

Date:

Facility Administrator/Staff:

The content here is provided for your general education and is not legal advice specific to your situation. You are welcome to use these ideas to stimulate your imagination and create your own voluntary discharge form or contact us or another attorney for help.

We can be reached at brian@pinkowskilaw.com if you have comments or questions about this topic.