SUPPORTED LIVING CONTRACT
Individual	Social Security #

This contract is entered into between Life's New Beginnings, Inc., subsequently referred to as the SL Program, and you as a Developmental Services Consumer, subsequently referred to as the Consumer.

The SL Program agrees to follow HRS Contract Guidelines to conduct evaluations and provide training and support to the Consumer.

After reviewing the concept of supported independent living, the Consumer must be willing to work through the program process. The SL Program will continue to provide services to the Consumer as long as he/she shows interest in and cooperates with the SL Program. The SL Program will not drop the Consumer simply for not attaining a skill. Every effort will be made to train the Consumer to attain said skill.

The Consumer is responsible for taking part in the following areas so that the SL Program can best serve him/her.

1.	Intake Interview.

2.	Intake Checklist.

3.	Application and follow-up for needed financial benefits (SSA, SSI, food stamps, etc).

4.	Application and follow-up for medical benefits if needed.

5.	Attend mental health counseling if needed.

6.	Cooperation with the Supported Living Coach in all areas of skills development which are listed in the Consumer's Support Plan.

The Consumer will also cooperate with the SL Program by following through with scheduled appointments, training sessions, quarterly meetings, and completing paperwork as required. Schedules will be set by the Consumer and Coach considering employment, work, and the social life of the Consumer.

The SL Program will be on call at all times to assist with emergency situations. The Consumer agrees to respect the privacy of SL Program staff by contacting staff only in an emergency situation. Messages can be left at the SL Program office by calling 841-7161.

This is a voluntary program. The Consumer may choose to leave the program at any time by signing an exit letter.

This contract begins on , and will end when the Consumer chooses to exit the SL Program or when the SL Program chooses to stop service to the Consumer by following the guidelines as determined by the HRS contract.

This is to certify that I have entered into an agreement with Life's New Beginnings, Inc., to provide the following service(s) (list):

Individual	Signature	Date
Client
Guardian
Staff/Title