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Authorization Form

Transportation & Outing Authorization

Use this form before support includes rides, errands, appointments, walks, community outings, or time away from the home. The goal is to confirm permission, boundaries, safety notes, and communication expectations.

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This authorization should be completed before transportation or community-based support begins. It can be updated if family preferences, safety needs, or approved destinations change.

Permission and boundaries
1

Authorization basics

Identify who this authorization is for and who is giving permission.

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2

Authorized transportation and outing support

Select the types of support that are allowed.

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3

Approved destinations and outing preferences

List common destinations and how outings should feel.

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4

Mobility, safety, and vehicle notes

Share anything that helps outings happen safely and respectfully.

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Colorado Homestead Care provides non-medical support. This form does not authorize emergency medical transportation, ambulance replacement, lift transfer services, or clinical care.

5

Money, purchases, and errands

Clarify expectations before errands involve purchases or personal funds.

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6

Communication during outings

Decide when families should be updated and who should be contacted.

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7

Emergency contacts and urgent situations

Confirm who should be contacted and what to do if urgent help is needed.

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If someone is in immediate danger or needs urgent medical attention, emergency services should be contacted. Colorado Homestead Care is not an emergency response or medical transport service.

8

Authorization acknowledgment

Typed signature confirms the authorization and boundaries listed above.

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Submitting this form saves the typed authorization details to the family record. Review this authorization before providing transportation or outing support.

Colorado Homestead Care · Keeping Families Together at Home · 719-299-0851 · care@coloradohomesteadcare.com