Printable blank LIC 603A Resident Appraisal

Fill Out Form
  •  Edit LIC 603A Resident Appraisal
  •  Fill out LIC 603A Resident Appraisal
    Fill out
  •  Sign LIC 603A Resident Appraisal
  •  Export LIC 603A Resident Appraisal

What is LIC 603A?

LIC 603A is a Resident Appraisal report form issued by the Social Services. It is to be filled out by prospective residents of residential care facilities for elderly people or their representatives in California.

What do I need the LIC 603A for?

  • Potential residents of senior health facilities offering long-term care located in California are required to fill out a LIC 603A appraisal blank on admission. In this form, the prospective resident or their responsible person provides information on the prospective resident’s state of health and medical conditions.
  • Note that the form does not substitute a physician report (LIC 602).

You don’t need LIC 603A if:

  • The care facility is not in California.

How to fill out LIC 603A?

To complete the Resident Appraisal form, download a free printable PDF version of the blank. If you prefer to fill it out electronically, make sure that it contains fillable data fields. 

  • Enter the resident’s name and age.
  • In Health, describe their overall health condition, mentioning any dietary restraints.
  • Proceed to enumerate physical disabilities, if any, describe the resident’s mental health and health history.
  • Under Social Factors, describe the person’s social preferences.
  • Proceed to tick fitting answers related to specific needs below.
  • If there is any additional information you need to add, use an additional sheet.
  • Add your signature and date at the bottom of Page 2.

Organizations that work with LIC 603A

  • Residential senior care facilities, California

Hear What PDFLiner Users Have to Say & Join Them Today

  • Fred Walters
    Now that I’ve switched from Word to PDFLiner, I save lots of time processing and digitally distributing tons of billing forms, work orders, forecast reports, and invoices. In addition to this, thanks to PDFLiner, we’ve significantly minimized our paper consumption. Excellent tool that helps me cope with my business workflow faster and easier.
  • Peter Scheffel
    Self-employed attorney
    PDFLiner allows me to streamline the processes of generating and managing legal documents, as well as collecting electronic signatures for all my contracts and agreements. I like that I can customize forms on the go and access PDFLiner from all my gadgets. No more printing or scanning! That’s just brilliant!
  • Lisa Matthews
    University student
    When you’re a student, you deal with PDFs a lot… Newsletters, various worksheets, official forms you need to fill in and sign, etc… To me, filling out a PDF form used to be among the trickiest and most time-consuming things ever. But then a friend of mine introduced me to PDFLiner, and oh my God, my life has changed since then. It’s easy to use and has so many great features. Just awesome, I love it!
Please, wait...
We use unpersonalized cookies to keep our site working and collect statistics for marketing purposes. By continuing to use this site, you consent to this policy. Learn more