Florida Department of Elder Affairs Client Disclosure Log DOEA Form 189
Form Template
When seeking mental health services or therapy, clients may disclose information about their personal lives.
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The Florida Department of Elder Affairs Client Disclosure Log DOEA Form 189 allows users to document type of information disclosed by a client, the recipient of the information, the client giving information, and Cares or Medicaid ID. The app can be used for adults residing in long-term care facilities (assisted living homes, adult day care, nursing homes, etc.). The app features a template that can log various accounts and is easy to fill out, edit, and save for records.
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