Direct care workers

Notice of Rights — Acknowledgment

Please review both documents below, then complete and e-sign the acknowledgment. Your signed form is sent to the United Home Care office.

Step 1 · Review these

📄 Colorado Wage & Hour Rights for Direct Care WorkersCDLE one-page fact sheet — opens the PDF 📄 Direct Care Worker Notice of RightsColorado DCW Notice of Rights printout — opens the PDF

Step 2 · Acknowledge & sign

Employee full name

Job title (optional)

Date of hire (optional)

Your email (optional, for your copy)

Notice(s) provided to me

Annual Direct Care Worker Notice of Rights Direct care worker-specific notice (HB 25-1328)

Provided by email / electronic Provided on paper

I acknowledge that United Home Care provided me with the notice(s) identified above and information on how to obtain assistance with my rights as a Colorado direct care worker. I understand that I may contact the Colorado Department of Labor and Employment with questions or concerns. My signature confirms receipt only; it does not mean that I agree with every statement, waive any rights, or confirm completion of any required training.

Signature (draw below)

Sign here with your mouse or finger

Or type your name below as your signature.

Typed signature (your full name)

Date