Attendant Change of Address Form

Use this form to notify ILRC of any change/correction to your mailing address. If you do not file this form, ILRC cannot be responsible for payroll check arriving at proper address.

Attendant Confidentiality Form

This is a form you must fill out and sign, pledging to never violate the confidentiality of the consumer for whom you work.

Attendant  Rights and Responsibilities

This is a form that must be signed, pertaining to an agreement of understanding for attendants of consumers of ILRC.

Direct Deposit Authorization

This is a form to provide necessary information for your payroll check to be directly deposited to your bank checking or savings account.

Employer Background Screening

The Family Care Safety Registry, administered by the Missouri Department of Health and Senior Services, provides families and other employers with a method to obtain background screening information. The Registry, through various state agencies, offers several resources to screen child-care, elder-care and personal care workers and child-care and elder-care providers:

Federal W-4 Form

The purpose of completing a Form W-4 is so your employer can withhold the correct federal income tax from your pay.

I-9 Form

This form is an employment eligibility verification form that is filed with the Dept. of Homeland Security through the U.S. Citizenship and Immigration Service.

Good Cause Waiver Application

This form is to determine if there has been any previous criminal record; child abuse or neglect; foster parent license denial, revocation or involuntary suspension; or any other history that needs to be documented.

Missouri W-4 Form

Form MO W-4 is completed so you can have as much "take-home pay" as possible without an income tax liability due to the state of Missouri when you file your return. Deductions and exemptions reduce the amount of your taxable income.

Orientation for New Attendants

This is a form that is filled out and signed by both the consumer and the attendant, demonstrating that they understand their responsibilities and have filed all the necessary paperwork prior to beginning employement.

Updated OHCDS

This is a Medicaid Attendant Care Contract; Non-Public Entity Organized Health Care Delivery System (OHCDS); Home and Community Based Services; Services to be Subcontracted by Independent Living Resource Center, Inc.

Worker Registration

Any person hired on or after January 1, 2001, as a child-care worker or elder-care worker, or hired on or after January 1, 2002 as a personal care worker, as defined in §210.900, subsection 2, RSMo, is required to make application for registration in the Family Care Safety Registry within fifteen (15) days of the beginning of employment.

Consumer Emergency Plan

Having an evacuation plan is very important in an emergency. Every second counts, so it’s important to prepare and practice an evacuation plan regularly. This form and information helps attendants know their role in the plan.