You can open the Family Caregiver Agreement Template in multiple formats, including PDF, Word, and Google Docs.
Family Caregiver Agreement Template Printable | Editable FormSample
[Name of the Caregiver]
[Caregiver’s ID]
[Caregiver’s Address]
[Caregiver’s Phone]
[Caregiver’s Email]
[Name of the Care Recipient]
[Recipient’s ID]
[Recipient’s Address]
This document formalizes the caregiver services agreement signed on [Contract Start Date], detailing the caregiving responsibilities to be provided by the Caregiver.
The Caregiver agrees to provide the following services: [Specify caregiving duties, such as personal care, assistance with daily activities, meal preparation, medication management, etc.].
The Care Recipient agrees to pay the Caregiver a fee of [Amount] to be settled on the following terms: [Specify payment schedule].
This agreement will commence on [Start Date] and will continue until [End Date], unless terminated earlier as specified herein.
This agreement may be terminated under the following circumstances: [Specify reasons such as mutual consent, change in care needs, etc.].
Both parties agree to maintain the confidentiality of sensitive personal health information of the Care Recipient.
This agreement will be governed by the laws of [State/Country].
[Signature of the Caregiver]
[Name of the Caregiver]
[Signature of the Care Recipient]
[Name of the Care Recipient]
[Name of the Caregiver]
[Caregiver’s ID]
[Caregiver’s Address]
[Caregiver’s Phone]
[Caregiver’s Email]
[Name of the Care Recipient]
[Recipient’s ID]
[Recipient’s Address]
This agreement outlines the expectations and responsibilities for caregiver services starting from [Contract Start Date].
The Caregiver will provide: [List specific caregiving duties such as transportation, companionship, errand running, etc.].
The Care Recipient agrees to compensate the Caregiver [Amount] per [hour/week/month] with the following payment schedule: [Specify terms].
Both parties agree to the following cancellation terms: [Specify notice period or reasons].
The Caregiver confirms that they have the necessary liability insurance, covering potential mishaps during caregiving.
This agreement may be reviewed and modified upon mutual consent of both parties at any time.
[Signature of the Caregiver]
[Name of the Caregiver]
[Signature of the Care Recipient]
[Name of the Care Recipient]
Form
Please complete the form below to create the Family Caregiver Agreement Template. All fields must be filled out to ensure a clear and complete agreement. We provide examples to guide you through each step. Family Caregiver Agreement Template 1. Caregiver Information 2. Care Recipient Information 3. Agreement Duration 4. Description of Services 5. Schedule of Care 6. Compensation Agreement 7. Confidentiality Agreement 8. Termination Conditions 9. Acceptance and Acknowledgment 10. Declarations and Signatures
PDF
WORD
Family Caregiver Agreement Template Printable | Editable FormPrintable
