Regulatory Addendum

⚖️ Acknowledgment of Pennsylvania Regulations on Financial and Legal Restrictions

In accordance with Pennsylvania state regulations (35 Pa. Stat. § 448.806b):

I am not permitted to endorse a check over to a home care agency or registry, including Silver Home Care.
I am not permitted to give or assign power of attorney to anyone employed by or affiliated with Silver Home Care.
I am not permitted to give or assign guardianship to anyone employed by or affiliated with Silver Home Care.
I have been provided with the opportunity to ask questions and understand my responsibility to comply with all relevant laws, regulations, and contract provisions.

✅ Acknowledgment of Receipt

I acknowledge that I have read and understand this regulatory addendum.

Client Name

Date

Representative Name

Relationship

Signature

Legal References:

35 Pa. Stat. § 448.806b: "No individual as a result of the individual's affiliation with a home care agency or home care registry may assume power of attorney or guardianship over a consumer utilizing the services of that home care agency or home care registry."

35 Pa. Stat. § 448.806b: "No consumer may be required to endorse checks over to a home care agency or home care registry."

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