GENTLE CARE AGENCY
AGENCY CLIENT AGREEMENT
Agreement between Agency and Client

---

This agreement is made by Gentle Care Agency hereinafter referred to as “the Agency” in agreement with the patient or any person acting on behalf of the patient hereinafter referred to as “the Client”.

The Agency is a bonded provider of homemaker services and is registered with the Office of the Secretary of the Stateof California. The Agency agrees to provide its services to the Client on the following terms and conditions.

   1. The Agency will use its reasonable efforts to refer independent, qualified, self-employed caregivers to provide homemaker services as offered in the Agency Brochure for the level of care and hours requested by the client

   2. The Client agrees not to hire any candidate referred to it by the Agency unless such action is in accordance with the terms of this agreement.
      a) The Client is liable for all actual loss of profit for the act of using a caregiver privately without notifying the Agency of such caregiver service.
      b) The Client is liable for all actual loss of profit for the act of canceling service with the intent to retain the caregiver’s services without the Agency’s knowledge.

   3. The Client agrees to pay the Agency as follows for its services under this Agreement:
      a) 35% of the total payments made to the Caregiver upon receipt of our Agency Fee Invoice,

   4. In the event that the Client cancels a scheduled shift without providing twenty-four (24) hours advance notice, the Client agrees to pay the caregiver for the entire cancelled shift.

   5. The Client acknowledges and agrees that the Agency has thoroughly screened and interviewed all caregiver applicants and deems the caregiver responsible and appropriate for in-home care. Therefore, the Agency shall not be held responsible for any negligence and/or misconduct on the part of a Caregiver. The Client agrees to indemnify, release and hold harmless the Agency from any and all liability on the part of the caregiver.

   6. The Client agrees that a Caregiver is considered an Independent Contractor and is responsible for his or her own taxes, and

   7. The Client agrees to furnish appropriate tax documentation annually to the caregiver and the tax authorities to verify total payments caregiver(s) earned.

   8. In the event any dispute arises relating to the interpretation or enforcement of this Agreement both parties agree to resolve any matter through outside mediation in attempt to resolve such dispute fairly.


          Client By signing below, Client agrees and accepts the terms and conditions of this Agreement and acknowledges that it has received a copy of this signed Agreement for his or her records.


          _________________________________________________
         Client Name (Please Print)           DATE


          _________________________________________________
         Client Signature


          _________________________________________________
         Billing Address


          _________________________________________________
         City, State, Zip Code

gentlecareagency@sbcglobal.net
www.gentle-care.com

HOME