On approval of the Rules for the provision of public services in the provision of special social services

Updated Unofficial translation

Order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated May 28, 2020 No. 197. Registered with the Ministry of Justice of the Republic of Kazakhstan on May 28, 2020 No. 20756.

      Unofficial translation

      In accordance with subparagraph 1) of Article 10 of the Law of the Republic of Kazakhstan “On Public Services” I HEREBY ORDER:

      Footnote. The preamble is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      1. To approve:

      1) Rules for the provision of public services "Registration of documents for the provision of special social services in medical and social institutions (organizations)" according to Appendix 1 to this order;

      2) The rules for the provision of the public service "Registration of documents for the provision of special social services in home care" in accordance with Annex 2 to this order.

      Footnote. Paragraph 1 as amended by the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 29.09.2021 № 357 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

      2. The Department for the Development of Social Services Policy of the Ministry of Labor and Social Protection of the Population of the Republic of Kazakhstan, in the manner prescribed by law, shall ensure:

      1) state registration of this order with the Ministry of Justice of the Republic of Kazakhstan;

      2) posting this order on the Internet resource of the Ministry of Labor and Social Protection of the Republic of Kazakhstan after its official publication;

      3) within ten working days after the state registration of this order, submission to the Department of Legal Service of the Ministry of Labor and Social Protection of the Republic of Kazakhstan information on the implementation of the measures provided for in subparagraphs 1) and 2) of this paragraph.

      3. Control over the implementation of this order shall be entrusted to the Vice-Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan, Ye.M. Aukenov.

      4. This order shall be enforced upon the expiration of ten calendar days after the day of its first official publication.

      Minister of Labor and
social protection of the population
Republic of Kazakhstan
B. Nurymbetov

      AGREED
Ministry of Digital Development,
innovation and aerospace
Republic of Kazakhstan

  Annex 1
to order the Minister of Labor and
social protection of the population
Republic of Kazakhstan
dated May 28, 2020 No. 197

Rules for the provision of public services "Registration of documents for the provision of special social services in medical and social institutions (organizations)"

      Footnote. Rules – in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 29.09.2021 № 357 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

Chapter 1. General provisions

      1. These Rules for the provision of a public service “Registration of documents for the provision of special social services in medical and social institutions (organizations)” (hereinafter - the Rules) have been developed in accordance with subparagraph 1) of Article 10 of the Law of the Republic of Kazakhstan “On State Services” and shall determine the procedure for the provision of a public service “Registration of documents for the provision of special social services in medical and social institutions (organizations)” (hereinafter - the public service).

      Footnote. Paragraph 1 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      2. The state service shall be provided by the local executive bodies of the cities of Nur-Sultan, Almaty and Shymkent, districts and cities of regional significance (hereinafter referred to as the service provider) to individuals (hereinafter referred to as the service recipient) in accordance with these Rules.

      Acceptance of the application and issuance of the result of the provision of public service shall be carried out through:

      1) non-profit joint-stock company "State corporation" Government for citizens "(hereinafter referred to as the State corporation);

      2) услугодателя;

      3) web portal "e-government" www.egov .kz (hereinafter referred to as the portal).

Chapter 2. Procedure for public serviceprovision

      3. To receive a public service, an individual (or his/her legal representative) shall apply to the service provider, the State corporation at the place of residence or through the portal by submitting an application in the form according to Appendices 1 or 2 to these Rules with the attachment of documents specified in the list of documents and information, required from the service recipient for the provision of a public service, provided for by the list of basic requirements for the provision of a public service in accordance with Appendix 3 to these Rules.

      Footnote. Paragraph 3 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      4. The requirements for the provision of a public service, including characteristics of the process, form, content and result of provision, as well as other information taking into account the specifics for the provision of a public service are given in the list of basic requirements for the provision of a public service in accordance with Appendix 3 to these Rules.

      Footnote. Paragraph 4 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      5. The total period for reviewing documents and issuing the results of the provision of public service from the date of receipt and registration of a package of documents by the service provider shall be seventeen working days.

      6. When submitting a full package of documents provided for by the list of basic requirements for the provision of a public service to the service recipient:

      in the State corporation - a receipt for acceptance of relevant documents shall be issued;

      the service provider - a coupon shall be issued indicating the date of registration and receipt of the public service, the name and initials of the person who accepted the documents;

      on the portal - in the "personal account" of the service recipient the status of acceptance of the request for the provision of public service shall be displayed.

      Footnote. Paragraph 6 as amended by the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      7. In the State corporation, the issuance of ready-made documents of the service recipient shall be carried out upon presentation of an identity document (or its representative by notarized notary or official performing notarial actions, power of attorney).

      Documents not issued on time due to the absence of the applicant's (representative's) appeal shall be stored in the State corporation for one month, after the expiration of this period they are returned to the service provider as unclaimed. When the service recipient applies after one month, at the request of the State corporation, the service provider within one working day sends the ready-made documents to the State corporation for issuance to the service recipient.

      8. In cases of submission by the service recipient of an incomplete package of documents in accordance with the list of basic requirements for the provision of a public service and (or) of expired documents, the employee of the service provider, the State corporation, upon acceptance, shall refuse to accept the application and issue a receipt of refusal to accept documents in the form according to Appendix 4 to these Rules.

      When the service recipient applies through the portal, the service provider sends the service recipient to the "personal account" a notification of refusal to further consider the application with an indication of what requirements the package of documents does not meet.

      Footnote. Paragraph 8 as amended by the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      9. If the package of documents specified in the list of basic requirements for the provision of a public service complies, the service provider’s specialist shall enter the data from the application of the applicant (family) being in difficult life situation into the automated information system “E-Sobes” (hereinafter - AIS “E-Sobes”).

      When a service recipient applies through the State corporation, the portal data from the application shall be automatically transferred to the AIS “E-Sobes”.

      Footnote. Paragraph 9 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      10. Information on the stage of provision of public services shall be received in an automated mode from AIS "E-Sobes" to the information system for monitoring the provision of public services.

      11. When applying to the State corporation, the day of receipt of documents shall not be included in the term of rendering the public service, while the result of rendering the state service by the service provider is provided to the State corporation the day before the end of the term of rendering the public service.

      12. After accepting the application and documents provided for in the list of basic requirements for the provision of a public service, on behalf of the service provider, the social worker shall assess and determine the need for special social services within 10 (ten) working days.

      Footnote. Paragraph 12 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      13. Within three working days from the date of receipt of the social worker's opinion on the assessment and determination of the need for special social services, the service provider makes a decision on the provision of special social services.

      14. After making a decision on the provision of special social services, the service provider at the place of residence of the service recipient within two working days sends a notification about the execution of documents and about the need for authorization and selection of a stationary, semi-stationary organization on the social services portal (http://aleumet.egov.kz).

      Footnote. Paragraph 14 – in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 10.12.2021 № 465 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

      15. The result of the provision of a public service shall be a notification of the execution of documents in any form indicating the period of provision of special social services in stationary and semi-stationary organizations, or a reasoned response to the refusal to provide a public service in cases and on the grounds provided for in paragraph 16 of these Rules.

      16. If there are grounds for refusal to provide a public service, provided for by the list of basic requirements for the provision of a public service, the service provider or the State corporation shall send a response to the service recipient indicating the reasons for the refusal.

      Footnote. Paragraph 16 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      17. In case of negative decision-making, the service provider shall notify the service recipient about the refusal to provide the state service, as well as the time and place (method) of hearing for the opportunity to express a position to the service recipient by a preliminary decision.

      The notification of hearing shall be sent at least 3 working days before the completion of the term of the provision of public service. The hearing shall be held no later than 2 working days from the date of notification.

      Based on the results of the hearing, the service provider shall issue a permit or a reasoned refusal to provide public service.

Chapter 3. Procedure for appealing decisions, actions (inaction) of the service provider and (or) its officials, the State Corporation and (or) their employees on the provision of public service

      18. Appeal against decisions, actions (inactions) of the service provider and (or) its officials, the State corporation and (or) their employees regarding the provision of a public service: the complaint shall be submitted to the head of the service provider, the State corporation at the addresses specified in the list of basic requirements for provision of a public service in accordance with Appendix 3 to these Rules.

      Confirmation of the complaint acceptance shall be its registration (stamp, incoming number and date) in the office of the service provider or the State corporation indicating the name and initials of the person who accepted the complaint, the time and place of receipt of the response to the complaint.

      Consideration of the complaint regarding the provision of public services shall be carried out by a higher administrative body, an official, an authorized body for assessing and monitoring the quality of the provision of public services (hereinafter referred to as the body considering the complaint).

      The complaint of the service recipient, received by the service provider or the State corporation, no later than three working days from the date of receipt and the administrative case shall be sent to the body considering the complaint.

      At the same time, the service provider, the State Corporation has the right not to send a complaint to the body considering the complaint, if it takes a decision or other administrative action within three working days that fully meets the requirements specified in the complaint.

      The complaint of the service recipient, received by the service provider, in accordance with subparagraph 2) of paragraph 3 of Article 25 of the Law of the Republic of Kazakhstan "On public services" shall be subject to consideration within five working days from the date of its registration.

      The complaint of the service recipient received by the body considering the complaint shall be subject to consideration within fifteen working days from the date of its registration.

      In cases of disagreement with the results of the provided state service, the recipient shall apply to the court in the manner established by the legislation of the Republic of Kazakhstan.

      Footnote. Paragraph 18 as amended by the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

  Annex 1
to Rules for provision of public
services "Registration of
documents for the provision of
special social services in medical
social institutions (organizations) "
  Form
 
  To the head of local executive
body or the state organization
authorized by local
executive body
____________________________
____________________________
(surname, name, patronymic
(if any) of the head of local
executive body or the
state organization authorized
by local executive body)
Business Identification number:
____________________________

      Identity document No. ___ issued by "___" ______ 20___

      Place of registration ________________________________________________________

      Place of residence ______________________________________________________________

      Place of birth ________________________________________________________

      Date of birth “___” _________ _____ year

      Type and amount of allowance ___________________________________________________

      Disability category _________________________________________________

      Availability of legal representatives

      _______________________________________________________________________

      (surname, name, patronymic (if any),

      individual identification number, relationship, age,

      social status, residential address, contact telephone number)

      Availability of relatives (able-bodied adult children, spouse)

      _______________________________________________________________________

      (surname, name, patronymic (if any), individual identification number, relationship, age, social status, residential address,

      contact number)

APPLICATION

      Footnote. Appendix 1 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      I hereby request to provide _____________________________________________

      (surname, name, patronymic (if any) of the service recipient)

      special social services in the conditions of round-the-clock permanent/temporary

      (underline as appropriate) residence in the organization of stationary type,

      since I need (needs) the provision of special social services in the conditions of a hospital.

      I am hereby attaching the following documents:

      1)________________________ 2) _________________________

      3) _______________________ 4) _________________________

      5) _______________________ 6) _________________________

      7) _______________________ 8) _________________________

      9) _______________________ 10) ________________________

      In accordance with Article 8 of the Law of the Republic of Kazakhstan “On Personal Data and Their Protection,” I am giving my consent to the collection and processing of my personal data of limited access, necessary for the registration of documents for the provision of special social services in organizations of stationary type.

      This consent shall be valid from the date of its signing until the day of completion of the provision of a public servic “Registration of documents for the provision of special social services in medical and social institutions and organizations of stationary type.”

      I hereby express my consent to the use of information about able-bodied adult children and spouse to determine the right for the provision of special social services, verification, harmonization and updating of relevant information in the information systems of state bodies, as well as to the use (transfer) of the information specified by me and information received from information systems, my status as a recipient of special social services in my interests, including the provision of a guaranteed volume of special social services.

      I have been warned of responsibility for providing false information and false (forged) documents.

      I am familiar with the conditions of admission, maintenance, transfer and discharge from an organization of stationary type.

      "___" ___________ 20___

      __________________________________________________________________

      (surname, name, patronymic (if any) and signature of the applicant)

      The documents have been accepted by _________________________________________________

      (position, surname, name, patronymic (if any) signature)

      "___" ___________ 20___.

  Annex 2
to Rules for provision of public
services "Registration of
documents for the provision of
special social services in medical
social institutions (organizations) "
  Form
 
  To the head of local executive
body or the state organization
authorized by local
executive body
____________________________
____________________________
(surname, name, patronymic
(if any) of the head of local
executive body or the
state organization authorized
by local executive body)
Business Identification number:
____________________________

APPLICATION

      Footnote. Appendix 2 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      I hereby request to provide __________________________________________________

      (surname, name, patronymic (if any) of the service recipient)

      “___” ___________ ______ year of birth, residing at

      ________________________________________________________________________

      special social services in the conditions of a day stay in a semi-stationary type organization,

      since I need (needs) the provision of special social services in the conditions of semi-stationary.

      I am hereby attaching the following documents:

      1)________________ 2) _________________

      3) ________________ 4) _________________

      5) ________________ 6) _________________

      7) ________________ 8) _________________

      9) ________________ 10) ________________

      In accordance with Article 8 of the Law of the Republic of Kazakhstan “On Personal Data and Their Protection,” I am giving my consent to the collection and processing of my personal data of limited access, necessary for the registration of documents for the provision of special social services to the organization of semi-stationary type.

      This consent shall be valid from the date of its signing until the day of completion of provision of a state service “Registration of documents for the provision of special social services in medical and social institutions and organizations.”

      I am familiar with the conditions of admission, stay, expulsion and discharge from a semi-stationary organization.

      "___" ________ 20___

      _____________________________________________________________________

      (surname, name, patronymic (if any) and signature of the applicant)

      The documents have been accepted by____________________________________________

      (position, surname, name, patronymic (if any) signature)

      "___" __________ 20___.

  Annex 3
to Rules for provision of public
services "Registration of
documents for the provision of
special social services in medical
social institutions (organizations) "

      Footnote. Appendix 3 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

List of basic requirements for the provision of a public service
“Registration of documents for the provision of special social services in medical and social institutions (organizations)”

1

Name of the service provider
 

Local executive bodies of the cities of Nur-Sultan, Almaty and Shymkent, districts and cities of regional significance (hereinafter - the service provider)

2

Methods of providing a public service
 

Acceptance of the application and issuance of the result of provision of a public service shall be
carried out through:
1) non-profit joint-stock company “State corporation “Government for Citizens” (hereinafter - the State corporation);
2) the service provider;
3) “electronic government” web portal www.egov.kz (hereinafter - the portal).

3

Term of provision of a public service
 

From the date of registration of the package of documents – 17 (seventeen) working days.
1) When applying to the State corporation, the day of receipt of documents shall not be included in the term for provision of a public service, while the result of provision of a piblic service by the service provider shall be provided to the State corporation the day before the end of the term for provision of a public service;
2) the maximum allowable waiting time for submitting a package of documents in the State corporation is 15 minutes, at the service provider - 30 minutes; 3) the maximum allowable service time for the service recipient at the State Corporation is 15 minutes, at the service provider - 30 minutes.

4

Form of provision and the result of the provision of a public service

Electronic (partially automated) / paper.

5

The result of provision of a public service
 

Notification about the registration of documents in any form indicating the term for provision of a public service, or a reasoned response about the refusal to provide a public service in the cases and on the grounds provided for in paragraph 9 of this list of basic requirements for the provision of a public service. When applying to the portal, the result of the provision of a public service shall be sent to the service recipient’s “personal account” in the form of an electronic document certified by an electronic digital signature of an official of the service provider.

6

The amount of payment charged from the service recipient when providing a public service, and methods of collecting it in cases provided for by the legislation of the Republic of Kazakhstan

Free of charge.

7

Work schedule of the service provider, the State corporation and information objects
 

1) State corporation - from Monday to Saturday inclusive, in accordance with the work schedule from 9.00 to 20.00 without a lunch break, except Sundays and holidays. Reception shall be carried out in an electronic queue, at the place of registration of the service recipient, without expedited service, it is possible to book an electronic queue through the “electronic government” web portal www.egov.kz;
2) service provider - from 9.00 to 18.00, 18.30, 19.00 with a lunch break from 13.00 to 14.00, 14.30, 15.00. Acceptance of an application and issuance of the result of the provision of public services from 9.00 to 17.30 with a lunch break from 13.00 to 14.30. Public services shall be provided on a first-come, first-served basis, without prior registration and expedited service;
3) portal - around the clock, with the exception of technical breaks due to repair works (when the service recipient applies after the end of working hours, on weekends and holidays in accordance with the Labor Code of the Republic of Kazakhstan, the application shall be accepted and the result of provision of a public service shall be issued on the next working day).

8

List of documents and information required from the service recipient for the provision of a public service

When applying for the provision of a public service, the service recipient (or his/her legal representative) shall submit the following documents to the service provider, the State Corporation or through the portal:
1) an application in the form according to Appendices 1 and 2 to the Rules for the provision of a public service “Registration of documents for the provision of special social services in medical and social institutions (organizations)” (hereinafter - the Rules);
2) an identification document or an electronic document from the digital document service of the service recipient with an individual identification number (hereinafter - IIN) (for identification);
3) a medical record in forms according to Appendices 5 and 6 to the Rules with an extract from an outpatient record or medical history.
Information about the identity document, about the establishment of disability (for the elderly if they have a disability), about the measures developed in the individual program of habilitation and rehabilitation of a person with a disability (hereinafter - IPR) (for the elderly if they have an IPR), about the recognition of a person over 18 years of age with psychoneurological diseases incapacitated by a court decision (if any), on retirement age, on the status of a veteran of the Great Patriotic War, a veteran of military operations on the territory of other states, as well as a veteran equal in benefits to veterans of the Great Patriotic War, families of deceased military personnel listed in subparagraph 1) of Article 8 of the Law of the Republic of Kazakhstan “On Veterans” (for veterans of the Great Patriotic War, veterans of military operations on the territory of other states, as well as veterans equal in benefits to veterans of the Great Patriotic War, families of deceased military personnel listed in subparagraph 1) of the Article 8 of the Law of the Republic of Kazakhstan “On Veterans”) shall be received by the service provider or the State corporation in the form of electronic documents certified by an electronic digital signature of authorized officials from the relevant state information systems. In the absence of information from information systems, a copy of the court decision declaring the person incompetent (if any) shall be attached to the application for persons over eighteen years of age.
Service providers receive digital documents from the digital documents service through the implemented integration, subject to the consent of the document owner provided through the user's cellular subscriber number registered on the e-government web portal by transmitting a one-time password or by sending a short text message as a response to a web notification of e-government portal.

9

Grounds for refusal to provide a public service established by the legislation of the Republic of Kazakhstan
 

1) establishing the unreliability of the documents submitted by the service recipient to receive a public service, and (or) the data (information) contained in them;
2) submission by the service recipient of expired documents and (or) an incomplete package of documents in accordance with the list provided for in paragraph 8 of this list of basic requirements for the provision of a public service;
3) non-compliance of the service recipient and (or) submitted materials, objects, data and information contained therein necessary for the provision of a public service, in accordance with the requirements established by the Rules for the activities of organizations providing special social services, approved by the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated August 29, 2018 No. 379 (registered in the Register of state registration of regulatory legal acts under No. 17467);
4) lack of consent of the service recipient, provided in accordance with Article 8 of the Law of the Republic of Kazakhstan “On Personal Data and Their Protection,” to access restricted personal data that is required for the provision of a public service.

10

Other requirements taking into account the specifics of the provision of a public service, including those provided in electronic form

For persons with disabilities, registration of documents for the provision of special social services in medical and social institutions (organizations) shall be carried out with the assistance of a social worker.
Addresses of places where a public service is provided are posted on the following Internet resources:
1) Ministry of Labor and Social Protection of the Population of the Republic of Kazakhstan – www.enbek.gov.kz, section “Public Services”;
2) State corporation – www.gov4c.kz;
3) portal www.egov.kz.
The service recipient has the opportunity to obtain information about the procedure and status of the provision of a public services through the service provider’s reference services, the Unified Contact Center “1414”, 8 800 080 7777.
The digital documents service is available to the users authorized in the mobile application.
To use a digital document, you must authorize in the mobile application using an electronic digital signature or a one-time password, then go to the “Digital documents” section and select the required document.

  Annex 4
to Rules for provision of public
services "Registration of
documents for the provision of
special social services in medical
social institutions (organizations) "
  Form

Receipt for refusal to accept documents

      Footnote. Appendix 4 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      Guided by Articles 19, 19-1, paragraph 2 of Article 20 of the Law of the Republic of Kazakhstan “On Public Services”,

      __________________________________________________________________________

      __________________________________________________________________________

      (local executive bodies of the cities of Nur-Sultan, Almaty and Shymkent, districts and cities

      of regional significance; non-profit joint-stock company "State corporation "Government

      for Citizens") refuses to accept documents for the provision of a service "Registration

      of documents for the provision of special social services in medical social institutions

      (organizations)" due to your submission of an incomplete package of documents and (or)

      expired documents/unreliability of documents/discrepancy between the service recipient

      and (or) submitted materials, objects, data and information necessary for the provision

      of a public service (underline as appropriate), namely:

      1) ______________________________________________;

      2) _______________________________________________;

      3) ______________________________________________.

      This receipt is made in 2 copies, one for each party.

      Executor:____________________________________________________________

      ________________________________________________________________________

      ________________________________________________________________________

      (surname, name, patronymic (if any) of the employee of the department of employment and

      social programs of districts, cities of regional and republican significance (capital), non-profit

      joint-stock company "State corporation "Government for Citizens", signature)

      Telephone: _______________________________

      Received:

      __________________________________________________________________________

      (surname, name, patronymic (if any) of the service recipient or legal representative, signature)

      "___" ____________ 20___.

  Annex 5
to Rules for provision of public
services "Registration of
documents for the provision of
special social services in medical
social institutions (organizations) "
  Form

MEDICAL RECORD for obtaining special social services in medical and social institutions (organizations) of stationary type

      Footnote. Appendix 5 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      ________________________________________________________________________

      (name of medical organization)

      Surname, name, patronymic (if any)

      ________________________________________________________________________

      Date of birth “____” _________ 20 __

      Home address _________________________________________________________

      Brief anamnesis (information about previous diseases; intolerance to drugs, foods, etc.):

      ________________________________________________________________________

      ________________________________________________________________________

      Medical examination (indicating the main and concomitant diagnosis, the presence of complications):


      neurologist ____________________________________________________________

      ________________________________________________________________________

      psychiatrist ________________________________________________________________

      ________________________________________________________________________

      dermatovenerologist ________________________________________________________

      ________________________________________________________________________

      phthisiatrician (fluorography data is required) ________________________

      ________________________________________________________________________

      therapist/pediatrician __________________________________________________________

      ________________________________________________________________________

      ________________________________________________________________________

      conclusion about the epidemiological environment: ______________________________

      ________________________________________________________________________

      According to indications (during dispensary registration):

      endocrinologist ____________________________________________________________

      cardiologist ________________________________________________________________

      orthopedist _________________________________________________________________

      narcologist ________________________________________________________________

      oncologist _________________________________________________________________

      gynecologist (urologist)______________________________________________________

      surgeon__________________________________________________________________

      ophthalmologist____________________________________________________________

      otolaryngologist___________________________________________________________

      Laboratory results: general blood test

      ________________________________________________________________________

      (date, result) blood test for HIV infection

      ________________________________________________________________________

      (date, result) blood test for syphilis

      ________________________________________________________________________

      (date, result) general urine test

      ________________________________________________________________________

      (date, result) parasitological examination of feces for helminth eggs

      ________________________________________________________________________

      (date, result) bacteriological examination of feces for E. coli

      ________________________________________________________________________

      (date, result) laboratory examination for meningococcal infection

      ________________________________________________________________________

      (date, result) for persons over 18 years of age with psychoneurological diseases:

      vaginal smear in women

      ________________________________________________________________________

      (date, result) urethral smear in men

      ________________________________________________________________________

      (date, result)

      Conclusion of the chairman of the medical advisory commission:

      ________________________________________________________________________

      ________________________________________________________________________

      (are there any medical contraindications for staying in an organization of stationary type)

      Place for seal

      Head of the medical organization: _________________________________

      (surname, name, patronymic (if any), signature)

      "__" _________ 20___

  Annex 6
to Rules for provision of public
services "Registration of
documents for the provision of
special social services in medical
social institutions (organizations) "
  Form
 

MEDICAL RECORD for obtaining special social services in medical and social institutions (organizations) of a semi-stationary type

      Footnote. Appendix 6 is in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

      _________________________________________________________________________

      (name of medical organization)

      Surname, name, patronymic (if any) _____________________________________

      Date of birth “___” ______ 20 ___

      Home address __________________________________________________________

      Brief anamnesis (information about previous diseases, intolerance to medicines, food products and so on):

      __________________________________________________________________________

      __________________________________________________________________________

      __________________________________________________________________________

      Medical examination (indicating the main and concomitant diagnosis, the presence of complications):

      neurologist ______________________________________________________________

      __________________________________________________________________________

      psychiatrist _________________________________________________________________

      __________________________________________________________________________

      dermatovenerologist ___________________________________________________________

      __________________________________________________________________________

      phthisiatrician (fluorography data is required) _________________________

      __________________________________________________________________________

      therapist/pediatrician __________________________________________________________

      __________________________________________________________________________

      __________________________________________________________________________

      conclusion about the epidemiological environment: _______________________________

      __________________________________________________________________________

      According to indications (during dispensary registration):

      endocrinologist ______________________________________________________________

      cardiologist ________________________________________________________________

      orthopedist ___________________________________________________________________

      narcologist _________________________________________________________________

      oncologist ___________________________________________________________________

      gynecologist (urologist)_________________________________________________________

      Laboratory results:

      general blood test _______________________________________________________

      (date, result)

      blood test for HIV infection _____________________________________________

      (date, result)

      blood test for syphilis _____________________________________________________

      (date, result)

      general urine test _______________________________________________________

      (date, result)

      parasitological examination of feces for helminth eggs

      __________________________________________________________________________

      (date, result)

      bacteriological examination of feces for E. coli

      __________________________________________________________________________

      (date, result)

      laboratory examination for meningococcal infection

      __________________________________________________________________________

      (date, result)

      for persons over 18 years of age with psychoneurological diseases: vaginal smear

      in women ________________________________________________________________

      (date, result)

      urethral smear in men ________________________________________________

      (date, result)

      Conclusion of the chairman of the medical advisory commission:

      __________________________________________________________________________

      __________________________________________________________________________

      (are there any medical contraindications for staying in the organization of semi-stationary type)

      Place for seal.

      Head of a medical organization:

      __________________________________________________________________________

      (surname, name, patronymic (if any), signature)

      Date "__" _________ 20___

  Appendix 2
to order Minister of Labor and
Social protection of the population
Republic of Kazakhstan
dated May 28, 2020 No. 197

Rules for the provision of public services “Registration of documents for the provision of special social services in the conditions of home care”

      Footnote. The Rules are in the wording of the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated 03.08.2022 No. 290 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).

Chapter 1. General provisions

      1. These Rules for the provision of a public service “Registration of documents for the provision of special social services in conditions of home care” (hereinafter - the Rules) have been developed in accordance with subparagraph 1) of Article 10 of the Law of the Republic of Kazakhstan “On Public Services” and shall determine the procedure for the provision of a public service “Registration of documents for the provision of special social services in the conditions of home care” (hereinafter - a public service).

      2. The public service shall be provided by local executive bodies of the cities of Nur-Sultan, Almaty and Shymkent, districts and cities of regional significance (hereinafter - the service provider) to individuals (hereinafter - the service recipient) in accordance with these Rules.

      Acceptance of the application and issuance of the result of a public service provision shall be carried out through:

      1) non-profit joint-stock company “State corporation “Government for Citizens” (hereinafter - the State corporation);

      2) the service provider;

      3) “electronic government” web portal www.egov.kz (hereinafter - the portal).

Chapter 2. The procedure for the provision of a public service

      3. To receive a public service, an individual (or his/her legal representative) shall apply to the service provider, the State corporation at the place of residence or through the portal by submitting an application in the form according to Appendix 1 to these Rules with the attachment of documents specified in the list of documents and information required from the service recipient for the provision of a public service provided for by the list of basic requirements for the provision of a public service in accordance with Appendix 2 to these Rules.

      4. Requirements for the provision of a public service, including characteristics of the process, form, content and result of provision, as well as other information taking into account the specifics of the provision of a public service, are given in the list of basic requirements for the provision of a public service in accordance with Appendix 2 to these Rules.

      5. The total period for consideration of documents and issuing results of the provision of a public service from the date of receipt and registration of the package of documents by the service provider is 14 (fourteen) working days.

      6. When submitting a full package of documents provided for in the list of basic requirements for the provision of a public service to the service recipient:

      in the State corporation - a receipt for acceptance of relevant documents shall be issued;

      at the service provider - a coupon, indicating the date of registration and receipt of a public service, surname and initials of the person who accepted the documents shall be issued;

      on the portal - in the “personal account” of the service recipient, the status of acceptance of the request for the provision of a public service shall be displayed.

      7. In the State corporation, the issuance of ready-made documents for the service recipient shall be carried out upon presentation of an identification document (or his/her representative under a power of attorney notarized by a notary or an official performing notarial acts).

      Documents not issued on time due to lack of request from the applicant (representative) shall be stored in the State corporation for one month, and after the expiration of this period they shall be returned to the service provider as unclaimed. When the service recipient applies after one month, at the request of the State corporation, the service provider within 1 (one) business day shall send the completed documents to the State corporation for issuance to the service recipient.

      8. In cases od submission by the service recipient of an incomplete package of documents in accordance with the list of basic requirements for the provision of a public service, and (or) expired documents, the employee of the service provider, the State corporation, upon acceptance, shall refuse to accept the application and issue a receipt of refusal to accept documents in the form of Appendix 3 to these Rules.

      When a service recipient applies through the portal, the service provider shall send a notification to the service recipient’s “personal account” about the refusal to further consider the application, indicating which requirements the package of documents does not meet.

      9. If the package of documents specified in the list of basic requirements for the provision of public services complies with the requirements, the service provider’s specialist shall enter the data from the application of the applicant (family) being in difficult life situation into the automated information system “E-Sobes” (hereinafter - AIS “E-Sobes”).

      When a service recipient applies through the State corporation, the portal, the data from the application shall be automatically transferred to the AIS “E-Sobes”.

      10. Information about the stage of provision of a public service shall be received automatically from the AIS “E-Sobes” into the information system for monitoring the provision of public services.

      11. When applying to the State corporation, the day of receipt of documents shall not be included in the period for provision of a public service, while the result of provision of a public service by the service provider shall be submitted to the State corporation the day before the end of the period for provision of a public service.

      12. After accepting the application and documents provided for in the list of basic requirements for the provision of a public service:

      a social worker, on behalf of the service provider, within 10 (ten) working days shall assess and determine the need for special social services and prepare an appropriate conclusion;

      the service provider’s specialist, within 5 (five) working days, shall go to the place of residence of a person with a disability or an elderly person and, within 3 (three) working days from the date of the survey, draw up an inspection report of housing and material conditions in the form according to Appendix 4 to these Rules.

      13. The service provider, within 3 (three) working days from the date of receipt of the social worker’s conclusion on assessing and determining the need for special social services and the report on the inspection of housing and material conditions, shall make a decision on the provision of special social services. After making a decision on the provision of special social services, the service provider at the place of residence of the service recipient, within 1 (one) working day, shall send a notification about the registration of documents and the need to authorize and select a home-based service organization on the social services portal (http://aleumet.egov.kz ).

      14. The result of the provision of a public service shall be a notification about the registration of documents in any form indicating the period for the provision of special social services in the conditions of home care, or a reasoned response about the refusal to provide a public service in cases and on the grounds provided for in the list of basic requirements for the provision of a public service.

      15. If there are grounds for refusal to provide a public service, provided for in the list of basic requirements for the provision of a public service, the service provider or the State corporation shall send a response to the service recipient indicating the reasons for the refusal.

      16. If the decision is negative, the service provider shall pre-notify the service recipient of the refusal to provide a public service, as well as the time and place (method) of the hearing in order to be able to express the service recipient’s position on the preliminary decision.

      Notification on the hearing shall be sent at least 3 (three) working days before the end of the period for providing a public service. The hearing shall be held no later than 2 (two) working days from the date of notification.

      Based on the results of the hearing, the service provider shall issue a permit or a reasoned refusal to provide a public service.

Chapter 3. The procedure for appealing decisions, actions (inaction) of service providers and (or) their officials, the State corporation and (or) their employees regarding the provision of a public service

      17. Appeal against decisions, actions (inactions) of the service provider and (or) its officials, the State corporation and (or) their employees regarding the provision of a public service: the complaint shall be submitted to the head of the service provider, the State corporation at the addresses specified in the list of basic requirements for provision of a public service in accordance with Appendix 2 to these Rules.

      The complaint shall be submitted in writing by mail or by hand through the office of the service provider or the State corporation.

      Confirmation of acceptance of the complaint shall be its registration (stamp, entry number and date) in the office of the service provider or the State corporation, indicating the surname and initials of the person who accepted the complaint, the date and place of receipt of the response to the filed complaint.

      Consideration of a complaint regarding the provision of public services shall be carried out by a higher administrative body, official, authorized body for assessing and monitoring the quality of provision of public services (hereinafter - the body considering the complaint).

      The complaint of the service recipient received by the service provider or the State corporation, no later than 3 (three) working days from the date of receipt and the administrative case shall be sent to the body considering the complaint.

      At the same time, the service provider, the State corporation shall have the right not to send a complaint to the body considering the complaint if it takes a decision or other administrative action within 3 (three) working days that fully meets the requirements specified in the complaint.

      The complaint of the service recipient received by the service provider or the State corporation shall be subject to consideration within 5 (five) working days from the date of its registration.

      The complaint of the service recipient received by the body considering the complaint shall be subject to consideration within 15 (fifteen) working days from the date of its registration.

      In cases of disagreement with the results of the provided public service, the service recipient shall apply to the court in accordance with the procedure established by the legislation of the Republic of Kazakhstan.

  Appendix 1 to the Rules
of a public service
"Registration of documents
for the provision of special
social services in the
conditions of home care"
 
  Form
 
  To the head of the local
executive body or the state
organization, authorized
by a local executive body
____________________________
____________________________
(surname, name, patronymic
(if any) of the head of local
executive body or the state
organization, authorized
by a local executive body)
Business identification number:
____________________________

APPLICATION

      I hereby ask to register ___________________________________________________

      (indicate surname, name, patronymic (if any) of the service recipient)

      for the provision of special social services in conditions of home care.

      Date of birth _______________________________________________________

      Residence address ___________________________________________________

      Phone number (home, mobile) ________________________________

      Disability category (if any) _________________________________

      Family members living together (indicate surname, name, patronymic

      (if any), individual identification number, relationship):

      ___________________________________________________________________

      ___________________________________________________________________

      ___________________________________________________________________

      In accordance with Article 8 of the Law of the Republic of Kazakhstan

      “On Personal Data and Their Protection,” I am giving my consent to the collection

      and processing of my limited access personal data necessary for processing documents

      for the provision of special social services in conditions of home care.

      This consent shall be valid from the date of its signing until the day of completion

      of the provision of a public service “Registration of documents for the provision

      of special social services in the conditions of home care.”

      I hereby express my consent to the use of information about able-bodied adult

      children and spouse to determine the right for the provision of special social services,

      verification, harmonization and updating of relevant information in the information

      systems of state bodies, as well as to the use (transfer) of the information specified

      by me and information received from information systems, my status as a recipient

      of special social services in my interests, including the provision of a guaranteed

      volume of special social services.

      I have been warned about the responsibility for providing false information and

      false (forged) documents.

      I am familiar with the procedure and conditions for the provision of special social

      services in conditions at home.

      I am attaching the following documents:

      __________________________________________________________________

      __________________________________________________________________

      __________________________________________________________________

      Surname, name, patronymic (if any) and signature ____________________

      __________________________________________________________________

      __________________________________________________________________

      Date "___" ___________ 20__

      The application has been accepted by _____________________________________

      (indicate surname, name, patronymic (if any) and position)

      Signature _________ Date “___” __________ 20__.

  Appendix 2 to the Rules
of a public service
"Registration of documents
for the provision of special
social services in the conditions
of home care"

List of basic requirements for the provision of a public service “Registration of documents for the provision of special social services in the conditions of home care”

1

Name of the service provider
 

Local executive bodies of the cities of Nur-Sultan, Almaty and Shymkent, districts and cities of regional significance (hereinafter - the service provider)

2

Methods of provision of a public service
 

Acceptance of the application and issuance of the result for the provision of a public service shall be carried out through:
1) non-profit joint-stock company “State corporation “Government for Citizens” (hereinafter - the State corporation);
2) the service provider;
3) “electronic government” web portal www.egov.kz (hereinafter - the portal).

3

Term of provision of a public service
 

From the date of registration of the package of documents – 14 (fourteen) working days.
When applying to the State corporation, the day of acceptance of documents shall not be included in the period for provision of a public service, while the result of the provision of a public service by the service provider shall be submitted to the State corporation the day before the end of the term for provision of a public service;
2) the maximum allowable waiting time for submitting a package of documents at the State corporation is 15 minutes, at the service provider - 30 minutes;
3) the maximum allowable service time for the service recipient at the State corporation is 15 minutes, at the service provider - 30 minutes.

4

The form of providing and provision of the result of a public service providing

Electronic (partially automated)/paper

5

The result of provision of a public service
 

Notification about the registration of documents in any form indicating the term for the provision of a public service, or a reasoned response about the refusal to provide a public service in the cases and on the grounds provided for in paragraph 9 of this list of basic requirements for the provision of a public service.
When applying to the portal, the result of the provision of a public service shall be sent to the service recipient’s “personal account” in the form of an electronic document certified by an electronic digital signature of an official of the service provider.

6

The amount of payment charged from the service recipient when providing a public service, and methods of collecting it in cases provided for by the legislation of the Republic of Kazakhstan

Free of charge

7

Work schedule of the service provider, the State corporation and information objects

1) State corporation - from Monday to Saturday inclusive, in accordance with the work schedule from 9.00 to 20.00 without a lunch break, except Sundays and holidays. Reception shall be carried out in an electronic queue, at the place of registration of the recipient, without expedited service, it is possible to book an electronic queue through the portal;
2) service provider - from 9.00 to 18.00, 18.30, 19.00 with a lunch break from 13.00 to 14.00, 14.30, 15.00. Acceptance of an application and issuance of the result of the provision of a public service from 9.00 to 17.30 with a lunch break from 13.00 to 14.30. Public service shall be provided on a first-come, first-served basis, without prior registration and expedited service;
3) portal - around the clock, with the exception of technical breaks due to repair works (when the service recipient applies after the end of working hours, on weekends and holidays in accordance with the Labor Code of the Republic of Kazakhstan, the application shall be accepted and the result of the provision of a public service shall be issued on the next working day).

8

List of documents and information required from the service recipient for the provision of a public service

When applying for the provision of a public service, the service recipient (or his/her legal representative) shall submit the following documents to the service provider, the State corporation or through the portal:
1) an application in the form according to Appendix 1 to the Rules for the provision of a public service “Registration of documents for the provision of special social services in conditions of home care” (hereinafter - the Rules);
2) an identification document or an electronic document from the digital document service of the service recipient with an individual identification number (hereinafter - IIN) (for personal identification);
3) a medical record in the form according to Appendix 5 to the Rules;
4) for children – a copy of the conclusion of the psychological, medical and pedagogical consultation.
Information about the identity document, about registration at permanent place of residence, about the determination of disability (for the elderly if they have a disability), about the measures developed in the individual program of habilitation and rehabilitation of a person with a disability (hereinafter - IPR) (for the elderly if they have an IPR), on retirement age, on the status of a veteran of the Great Patriotic War, a veteran of military operations on the territory of other states, as well as a veteran equal in benefits to veterans of the Great Patriotic War, families of deceased military personnel listed in subparagraph 1) of Article 8 of the Law of the Republic of Kazakhstan “On Veterans”" (for veterans of the Great Patriotic War, veterans of military operations on the territory of other states, as well as veterans equal in benefits to veterans of the Great Patriotic War, families of deceased military personnel listed in subparagraph 1) of Article 8 of the Law of the Republic of Kazakhstan “On Veterans”) the service provider, the State corporation receives in the form of electronic documents certified by an electronic digital signature of authorized officials from the relevant state information systems.
Service providers receive digital documents from the digital document service through the implemented integration, subject to the consent of the document owner provided through the user's cellular subscriber number registered on the e-government web portal by transmitting a one-time password or by sending a short text message as a response to a notification of e-government web-portal.

9

Grounds for refusal to provide a public service established by the legislation of the Republic of Kazakhstan
 

The grounds for refusal to provide public services shall be:
1) establishing the unreliability of the documents submitted by the service recipient to receive a public service, and (or) the data (information) contained in them;
2) submission by the service recipient of expired documents and (or) an incomplete package of documents in accordance with the list provided for in paragraph 8 of this list of basic requirements for the provision of a public service;
3) non-compliance of the service recipient and (or) submitted materials, objects, data and information necessary for the provision of a public service, in accordance with the requirements established by the Rules for the activities of organizations providing special social services, approved by the order of the Minister of Labor and Social Protection of the Population of the Republic of Kazakhstan dated August 29, 2018 No. 379 (registered in the Register of state registration of regulatory legal acts under No. 17467);
4) lack of consent of the service recipient, provided in accordance with Article 8 of the Law of the Republic of Kazakhstan “On Personal Data and Their Protection,” to access restricted personal data that is required for the provision of a public service.

10

Other requirements taking into account the specifics of the provision of a public service, including those provided in electronic form

For persons with disabilities, registration of documents for the provision of special social services in the conditions of home care shall be carried out with the assistance of a social worker. Addresses of places of a public service provision are posted on the following Internet resources:
1) Ministry of Labor and Social Protection of the Population of the Republic of Kazakhstan – www.enbek.gov.kz, section “Public Services”;
2) State corporation – www.gov4c.kz;
3) portal www.egov.kz. The service recipient shall have the opportunity to obtain information about the procedure and status of provision of a public service through the service provider’s reference services, the Unified Contact Center “1414”, 8 800 080 7777. The digital document service is available to the users authorized in the mobile application. To use a digital document, you must authorize in the mobile application using an electronic digital signature or a one-time password, then go to the “Digital documents” section and select the required document.

  Appendix 3 to the Rules
of a public service
"Registration of documents
for the provision of special
social services in the conditions
of home care"

      Form

Receipt for refusal to accept documents

      Guided by Articles 19, 19-1, paragraph 2 of Article 20 of the Law of the Republic of Kazakhstan

      "On public services"

      __________________________________________________________________________

      __________________________________________________________________________

      (local executive bodies of the cities of Nur-Sultan, Almaty and Shymkent, districts and cities

      of regional significance; non-profit joint-stock company "State corporation "Government for Citizens")

      shall refuse to accept documents for the provision of a public service "Registration of documents

      for the provision of special social services in the conditions of home care" due to your submission

      of an incomplete package of documents and (or) expired documents/unreliability

      of documents/inconsistency of the recipient of services and (or) the submitted materials,

      objects, data and information necessary for the provision of a public service (underline as necessary),

      namely :

      1) _____________________________________________________________;

      2) ______________________________________________________________;

      3) ______________________________________________________________.

      This receipt is made in 2 copies, one for each party.

      Executor:___________________________________________________

      ______________________________________________________________

      (surname, name, patronymic (if any) of the employee of the department of employment and

      social programs of districts, cities of regional and republican significance (capital), akimat of a city

      of regional significance, village, town, rural district of the non-profit joint-stock company

      "State corporation "Government for Citizens", signature)

      Telephone: ______________________________________________________

      Received: ______________________________________________________

      ______________________________________________________________

      (surname, name, patronymic (if any) of the recipient of services or legal representative, signature)

      "___" ____________ 20___.

  Appendix 4 to the Rules
of a public service
"Registration of documents
for the provision of special
social services in the conditions
of home care"

      Form

ACT No. _________ of survey of housing and material conditions *

      1. Surname, name, patronymic (if any) of the recipient of services

      ________________________________________________________________________

      ________________________________________________________________________

      2. Date of birth “___” ___________ ______ year

      3. Residence address _____________________________________________________

      4. Phone number ________________________________________________________________

      5. Type and amount of allowance (pension) __________________________________________

      6. Marital status ___________________________________________________

      7. Last place of work ________________________________________________

      8. Information about children and close relatives (surname, name, patronymic (if any),

      place of residence, place of work, contact numbers):

      _______________________________________________________________________

      _______________________________________________________________________

      _______________________________________________________________________

      9. Living conditions: ___________________________________________________

      (comfortable/uncomfortable housing)

      _______________________________________________________________________

      (apartment, private house, dorm room, etc.)

      _______________________________________________________________________

      (indicate floor, number of rooms, availability of bathrooms, central heating,

      elevator and so on)

      _______________________________________________________________________

      (other conditions)

      10. Availability of a personal plot ________________________________________

      The person who drew up the act ___________ ________________________________________

      (signature) (surname, name, patronymic (if any), position)

      Date "___" _________ 20___

      Note: filled in for persons with disabilities and the elderly.

  Appendix 5 to the Rules
of a public service
"Registration of documents
for the provision of special
social services in the conditions
of home care"

      Form

MEDICAL RECORD for obtaining special social services in the conditions of home care

      __________________________________________________________________________

      (name of medical organization)

      Surname, name, patronymic (if any)

      __________________________________________________________________________

      Date of birth "___" ______ ______ year

      Home address _______________________________________________________________

      Brief anamnesis (information about previous diseases, intolerance to medicines, food products and so on):

      __________________________________________________________________________

      __________________________________________________________________________

      __________________________________________________________________________

      Medical examination (indicating the main and concomitant diagnosis, the presence of complications):

      neurologist ______________________________________________________________

      __________________________________________________________________________

      psychiatrist ___________________________________________________________________

      __________________________________________________________________________

      dermatovenerologist __________________________________________________________

      __________________________________________________________________________

      phthisiatrician (fluorography data is required) __________________________

      __________________________________________________________________________

      therapist/pediatrician _________________________________________________________

      __________________________________________________________________________

      __________________________________________________________________________

      conclusion about the epidemiological environment:

      __________________________________________________________________________

      Laboratory results: general blood test

      __________________________________________________________________________

      (date, result)

      general urine test ________________________________________________________

      (date, result)

      bacteriological examination of feces for E. coli

      __________________________________________________________________________

      (date, result)

      Conclusion of the chairman of the medical advisory commission:

      __________________________________________________________________________

      __________________________________________________________________________

      (are there any medical contraindications for staying in the organization of home-based service)

      Place for seal.

      Head of the medical organization: _____________________________________________

      (surname, name, patronymic (if any), signature)

      Date "___" ________ 20__

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