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Sample Caregiver Contract

This is based on of a document developed by Suzanne Howle of the law firm Thompson and Howle in Seattle.

WARNING. As with any form contract, or, for that matter, any legal information obtained on the internet, it is highly unwise to make uncritical use of this sample. Users are strongly urged to seek legal advice before making any legal arrangement using this sample.

SERVICE AGREEMENT

1.         The parties to this agreement are: 
_____________________________, who will be referred to in this document as “Client”, who is to receive care and assistance.

Employer, Guardianship Services of Seattle (GSS), acting in the name of Client in the following capacity: ❒ guardian ❒ attorney-in-fact ❒ _______________________.

Employee, _______________________________, who will be referred to as “Caregiver”. Caregiver’s address and telephone number are:

2.         The purpose of this agreement is to set out the terms of employment and to establish what assistance Caregiver will provide to Client.

3.         Client is a person with impaired abilities, and is a vulnerable person. Client is dependant on Caregiver and is not able to deal with Caregiver on equal terms. Caregiver will take special care not to take advantage of Client and not to unnecessarily influence Client’s choices. Caregiver will not negotiate terms of employment with Client. Caregiver will immediately disclose to GSS all gifts from Client, and will return any gifts that GSS decides are excessive. Caregiver will under no circumstances assist Client to write checks unless authorized to do so in writing by GSS. Caregiver will not influence Client in any way whatsoever regarding the writing of a will or other estate planning.

4.         Caregiver will assist Client to live at home and to have as much control over the home environment and life as possible, under the circumstances.

5.         Caregiver will be responsible directly to GSS to direct and approve the actions of Caregiver. Services provided may include any of the following:

Personal Services: Assistance with the activities of daily living such as bathing, dressing, feeding, and other activities detailed the Caregiver's Notebook.

Personal Care: Assistance carrying out physicians directions regarding care of Client, carrying out the Care Plan, assistance with mobility and transfers, record keeping, preventing Client from wandering or otherwise harming self.

Household Services: Meal preparation according to a plan approved by GSS, shopping, errands, house cleaning, laundry.

Record Keeping: Caregiver will keep records as set out in Caregiver’s Notebook.

Caregiver will accompany Client on errands and appointments as directed by GSS.

Caregiver will know the whereabouts and the physical condition of Client at all times while on duty, and will keep GSS informed of any changes.

Caregiver will make a written record of any accidents or other sudden events that bring harm or risk of harm to Client. Caregiver will make use of emergency contact procedures to speak with a GSS representative personally about any such incidents.

Other services as agreed between caregiver and GSS.

6.         Driving.

[check if applicable] Caregiver states that s/he has a valid Washington State Driver's License, and agrees to provide a copy of such license.
[Choose one]

❒ Caregiver will provide transportation for Client in Client's vehicle to appointments, errands, shopping, and for social purposes. GSS is responsible for maintaining appropriate insurance coverage.

❒ Caregiver will provide transportation for Client in Caregiver's vehicle to appointments, errands, shopping, and for social purposes. Caregiver agrees to provide proof of liability and uninsured motorist insurance with policy limits of at least: $ 100,000.00 for bodily injury, $300,000.00 per incident maximum, and $50,000.00 property damage. Caregiver promises to notify GSS immediately if insurance is terminated. If use of the caregivers auto for work purposes is routine, caregiver will notify caregivers auto insurance carrier,

7.         Work Schedule. Caregiver agrees to work according to a schedule established by GSS in consultation with Client, and will not alter the schedule without at least 48 hours advance notice to GSS (to allow GSS to approve the alteration or make other arrangements.) Caregiver will not revise this schedule without the consent of GSS.

8.         Household Expenses. If Caregiver is provided with funds for household expenses, Caregiver will keep detailed records on forms provided by GSS. Caregiver will only make purchases that are approved by GSS.

9.         Probation Period. During the first three months or employment GSS may terminate this agreement at any time with or without notice and without severance pay.

10.       Termination. This agreement may be terminated at will by either GSS or caregiver with two (2) weeks advance written notice.

            GSS may terminate employment without cause with no advance notice. If this occurs, Caregiver will be entitled to two weeks severance pay at the rate of the average compensation over the past three months.

            GSS may terminate employment with no advance notice and no severance pay if Caregiver has violated the terms of this agreement, or has been negligent, or acted in a way that could have allowed harm to Client.

11.       This agreement will be interpreted according to the laws of the State of Washington. In any proceeding in which this agreement is construed or interpreted against its drafter, that construction or interpretation will not apply, and this agreement will be construed or interpreted to give effect to the parties' intent in accordance with the terms of this agreement.

12.       Legal Representation. Caregiver acknowledges that s/he was told that s/he was free to consult with a lawyer to review this agreement prior to signing it and had ample opportunity to do so. Caregiver acknowledges that this is an arms-length transaction in which she was free to negotiate and did negotiate the terms of this agreement.

13.       Attorney's Fees. In the event of any breach of this agreement, the party responsible for the breach agrees to pay reasonable attorneys' fees and costs incurred by the other party in the enforcement of this agreement or suit for recovery of damages. The prevailing party in any suit instituted arising out of this agreement will be entitled to receive reasonable attorneys' fees and costs incurred in such suit.

14.       Hours, Compensation. The hours and hourly compensation of caregiver are subject to change at any time as agreed between Caregiver and GSS. The initial arrangement is as follows:

            Hours/days     ____________________________________________________

            Compensation ____________________________________________________
 

_____________________________________                      ________________________
Client, by Guardianship Services of Seattle                                Date
 

_____________________________________                      ________________________
Caregiver