Home Health Care Service Agreement Form

If the caregiver`s employee status is a W-9 agent, Exposure A should be used on the last page to define the benefits of caregivers and disclose certain important information when such employment status is recorded. Once this page is filled out and read by both parties, everyone must sign their name and indicate the calendar date when they signed this page. When a caregiver and dependent employee have an employment relationship, it is often recommended to ensure that the employment contract is fixed on paper. This type of documentation is available using the buttons that label the image on this page. You can download any file version (Adobe PDF, Microsoft Word (.docx) or Open Document Text (.odt)) of this model at your own discretion. Well, on the empty line called “recipient,” you produce the full name of the person who will receive the services of the concierge. Finally, use the last empty line here to present the full name of the manager. Medical Procuration – Gives caregivers the right to make health decisions on behalf of someone else. This is common practice when the patient is unable to speak for himself or herself and a caregiver is entrusted with the obligation to make decisions for the good of the patient. This form also contains a living will that allows the patient to make “end-of-life” decisions if he is in a state of guardianship for a long time. A guardian is someone who is paid to care for another person, usually an elderly person or someone with special needs. A tutor is paid for daily care such as transportation, meal preparation, household management and other individual needs.

As a general rule, the tutor will follow a weekly schedule set either in the agreement or by the parties. If the hired guardian is a family member or friend who lives in the same house, there may be tax benefits for the employer. Simply put, if the caregiver is there to “care” for the patient and does not give up more than 20% of his daily activities, the caregiver cannot be entitled to a minimum wage. “VI. Services To Perform” is the section in which we describe exactly what tasks the manager will perform when employed by the recipient.