DAFORMFILLABLE.COM | DA FORM 5189 Fillable – Army Pubs 5189 PDF – DA FORM 5189, titled Application For Respite Care For Children And Adults With Disabilities, is a crucial document used within the Department of the Army. This form is designed to provide respite care for children and adults with disabilities, ensuring they receive the necessary support and care.
DA FORM 5189 – Application For Respite Care For Children And Adults With Disabilities
| Form Number | DA Form 5189 |
| Form Title | Application For Respite Care For Children And Adults With Disabilities |
| Form Date | 09/01/2002 |
| Form Proponent | G-9 |
Purpose of DA FORM 5189
The primary purpose of DA FORM 5189 is to facilitate the application process for obtaining respite care services. Respite care provides temporary relief for primary caregivers, allowing them to take a break while ensuring that the person with a disability receives the care they need.
Key Information
Publication Details
- Pub/Form Number: DA FORM 5189
- Pub/Form Date: 09/01/2002
- Pub/Form Title: Application For Respite Care For Children And Adults With Disabilities
- Pub/Form Proponent: G-9
- Pub/Form Status: ACTIVE
- Prescribed Forms/Prescribing Directive: AR 608-75
- Security Classification: UNCLASSIFIED
- Dist Restriction Code: A – APPROVED FOR PUBLIC RELEASE; DISTRIBUTION IS UNLIMITED
- Pub/Form IDN: 990001
- Pub/Form PIN: 053293
Importance of Respite Care
Respite care is essential for maintaining the health and well-being of both caregivers and individuals with disabilities. It provides a much-needed break for caregivers, reducing stress and preventing burnout. For individuals with disabilities, respite care offers a change of environment and routine, which can be beneficial for their overall well-being.
How to Complete DA FORM 5189
Step-by-Step Instructions
Section 1: Applicant Information
This section requires the basic information of the applicant, including name, address, and contact details. Ensure all fields are filled accurately to avoid any delays in processing.
Section 2: Details of the Person Needing Respite Care
Provide comprehensive details about the individual requiring respite care. This includes their name, date of birth, disability details, and the type of care they need.
Section 3: Caregiver Information
Include the caregiver’s information, focusing on their relationship to the person needing care, their contact details, and any relevant background that supports the need for respite care.
Section 4: Respite Care Details
Specify the type of respite care required, the duration, and any special requirements. Be clear and detailed to ensure that the care provided meets the needs of the individual.
Section 5: Certification and Signature
The final section requires the certification of the information provided and the signature of the applicant. This confirms that all details are accurate and truthful.
Guidelines and Considerations
Compliance with AR 608-75
DA FORM 5189 is prescribed by AR 608-75, which outlines the Army’s policies for the Exceptional Family Member Program (EFMP). Adhering to these guidelines ensures that the application process is smooth and compliant with military regulations.
Electronic Media and Distribution
This form is available only in electronic media and can be distributed without restrictions, making it easily accessible for those who need it. Ensure to download the latest version to stay updated with any changes or updates.
Conclusion
DA FORM 5189 – Application For Respite Care For Children And Adults With Disabilities plays a vital role in supporting families and caregivers within the Army community. By understanding the form’s purpose, following the completion instructions, and complying with relevant directives, applicants can effectively utilize this resource to access necessary respite care services.
Respite care not only benefits the caregivers by providing them with essential breaks but also ensures that individuals with disabilities receive consistent and quality care. Proper use of DA FORM 5189 contributes to the overall well-being and stability of Army families.
DA FORM 5189 Fillable – Army Pubs 5189 PDF DOWNLOAD
