Allegato 3A.
PATTO PER LA CURA

Obiettivi di cura che si intendono perseguire, connessi a salute, relazioni affettive e di cura, relazioni sociali, autonomia ed autosufficienza personale, mobilità, espressione personale (a titolo esemplificativo, ma non esaustivo) e indicazione in mesi della durata del patto:
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Condizione attuale (Specificare brevemente): ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Necessità della persona (Specificare brevemente): ___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Impegni del caregiver familiare, modalità di monitoraggio del buon andamento e del perseguimento degli obiettivi previsti dal Patto per la cura 
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Data e luogo, __________________________	Firma CAREGIVER ______________________________
				
Firma della persona con disabilità (o del suo amministratore di sostegno, curatore o tutore) ______________________

						Firma Case manager _____________________________