Caregiver agreements may vary depending on the caregiver’s responsibilities, but they are intended to ensure that all parties are on the same page about the scope of care and can help legally protect those being cared for. You can use this caregiver agreement template to customize it for your situation.
This Caregiver Agreement ("Agreement") is effective as of [Document.CreatedDate] between:
[Client.FirstName] [Client.LastName] , who resides at [Client.StreetAddress] , [Client.City] , [Client.State] [Client.PostalCode] ("Client"), and
[Caregiver.FirstName] [Caregiver.LastName] who resides at [Caregiver.StreetAddress] , [Caregiver.City] , [Caregiver.State] [Caregiver.PostalCode] ("Caregiver").
The purpose of this Agreement is to outline the role and responsibilities of the Caregiver in assisting the Client with the tasks of daily living. It also contains information about the compensation terms for the Caregiver.
The Caregiver agrees to perform their responsibilities on the following schedule:
The schedule is subject to change based on the needs of the Client. If the Caregiver cannot attend work due to illness or injury, they must contact the Client as soon as possible via phone.
In some situations, caregivers may work on an as-needed basis rather than a set schedule. If this is the case, specify in this section that the work schedule varies.
W-9 Employee: The Caregiver will be recognized as a W-9 employee by the Client. The Client will withhold taxes from the Caregiver's pay and provide the Caregiver with the proper tax forms. Additionally, the Caregiver is entitled to employment rights.
1099 Independent Contractor: The Caregiver is working individually for the Client and agrees to pay any taxes and report their earnings to the government.
(Check all that apply)
The Client agrees to pay the Caregiver $(amount) per (insert time, e.g., hourly, daily, monthly). The Caregiver will receive a direct deposit of the amount owed on the (insert date) and (insert date) of every month. If these dates fall on the weekend or are a holiday, the payment will be processed the following business day.
We’ve included a standard bimonthly payment schedule in this section. You can adapt this section if you prefer a different payment schedule, such as monthly or weekly.
Full Room and Board: The Client agrees to provide the Caregiver with room and board, including a personal room, and will pay for all expenses, including (insert utilities covered, e.g., electric, water, internet, cable).
Room and Board Reimbursement: The Client agrees to reimburse the Caregiver for all costs associated with room and board, including (insert utilities and amenities covered, e.g., groceries, rent, electric, water, internet, cable) up to $(amount) per month.
This section is optional. If you choose not to offer room and board in addition to compensation, you can delete this section of the contract.
The Caregiver will be reimbursed for any costs associated with caregiving. Additionally, the Caregiver will have access to a reliable vehicle and be reimbursed for any mileage costs at current rates. The Caregiver will submit expense reports at the end of each month.
Providing access to a vehicle and reimbursing the caregiver for mileage is optional. You can remove this language if desired.
The Client will provide the Caregiver with the following benefits in addition to the compensation listed above:
Health insurance reimbursement for up to $(amount) per month.
Continuing education reimbursement for up to $(amount) per year
Transportation reimbursement for up to $(amount) per month
The benefits section lists several possible benefits that may be offered to the caregiver. You can add or remove benefits from this section to suit your situation.
The Caregiver is entitled to (insert number of hours or days) of paid sick leave per year.
The Caregiver is entitled to (insert number) of paid vacation days per year. The Caregiver must give the Client a minimum of (insert number) days' notice prior to taking vacation days.
Creating a plan for a caregiver’s absence can help ensure continuity of care. You may wish to include information in this section about a relief caregiver, a family member who can provide care, or another solution, such as adult daycare.
(Check all that apply)
The Caregiver is responsible for performing the following caretaking tasks for the Client:
Transporting the Client to any healthcare appointments
Taking notes about the information discussed during healthcare appointments
Scheduling any follow-up healthcare tests or appointments
Picking up prescriptions and other medical supplies
Administering and monitoring medication
Planning and preparing (insert number) of snacks and (insert number) of meals per day
Grocery shopping for planned meals and other items requested by the Client
Serving prepared snacks and meals
Washing and putting away dishes
Preparing drinks, such as coffee and tea
Laundering and changing bed linens
Cleaning counters and appliances
Vacuuming carpets and rugs
Washing hardwood floors
Washing, drying, folding, and putting away laundry items, including towels and clothing
Caring for lawns and gardens, including watering, weeding, raking leaves, and mowing lawns
Shoveling snow and applying de-icer as needed
Caring for pets
Sorting recycling and taking out garbage and recycling
Cleaning sinks and bathrooms
Assist with dressing
Assist with self-administration of medication
Assist with personal grooming
Assist with bathing and/or toiletries
Assist with walking
Assist with exercises
Playing cards or board games
Reading out loud
Going on walks or sitting outside
General companionship and conversation
In this section, we’ve provided examples of different caregiver tasks and categories. Because caregiving tasks can vary depending on the client’s needs, add or remove tasks to this section to suit your situation.
This contract can be terminated at any time with (insert time, e.g., days, weeks) notice from either party. Additionally, illegal conduct committed by the caregiver will result in immediate termination of the contract.
In the terms for termination section, we listed general causes for termination. You may wish to be more specific about possible grounds for termination, such as sharing pictures of the client on social media accounts or consistent tardiness.
THE STATE OF [Notary.State]
COUNTY OF (Insert)
MM / DD / YYYYThis instrument was acknowledged before me on (date) by [Notary.FirstName] [Notary.LastName] .
Notary Public
(Notary Stamp)
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A caregiver agreement, also known as a caregiver contract, is an agreement between an individual providing care for a client. The agreement exists to outline the duties the caregiver is responsible for and the compensation and benefits for the caregiver. This contract is notarized to protect all parties.
The first step to writing a caregiver contract is to meet with all family members involved in the individual’s care to determine their needs. This information can then be used to draft a caregiver contract listing the caregiver’s responsibilities. To make this process simpler, you can also use a template, such as PandaDoc’s Caregiver Agreement Template. Meeting with a lawyer can help ensure that the contract is accurate and free of any errors.
There are generally four main types of caregivers: home healthcare, assisted living facilities, nursing homes, and adult daycare centers. They differ in terms of the level of care that is provided.
Unlicensed caregivers are not allowed to provide medical care. This may include administering medication, providing medical care, assessing a client’s health status, or providing advice about medication or health issues.
A caregiver assists an individual with the tasks of daily living. Job duties can vary based on the needs of the individual they are caring for but may include transportation, personal care, companionship, healthcare support, meal preparation, and housework.
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