Home Care Services Agreement – Caregiver Contract for In-Home Senior & Personal Care

Create clear expectations between a caregiver and client with this professional Home Care Services Agreement & Caregiver Contract Template.
Designed for independent caregivers, home care providers, personal care professionals, senior care providers, and in-home caregiving services, this customizable agreement provides an organized way to document the scope of care, service schedule, compensation, responsibilities, home access, emergency contacts, confidentiality, and other important caregiving terms.

Whether care involves personal assistance, senior support, companionship, or other in-home services, this agreement provides a professional starting point for documenting the caregiving arrangement.

WHAT’S INCLUDED
This Home Care Services Agreement includes sections for:
• Client / Patient Information
• Caregiver / Healthcare Agent Information
• Service Location
• Start Date
• Care Schedule
• Days & Hours of Service
• Scope of Care Services
• Included Care Tasks
• Excluded Services
• Caregiver Qualifications
• Certifications & Experience
• Home Access
• Keys & Access Codes
• Authorized Areas of the Home
• Emergency Contact Information
• Primary Physician Information
• Authorized Decision-Maker / Medical Proxy Information
• Standard of Care
• Compensation & Base Rate
• Payment Frequency
• Holiday Rates
• Overtime Rates
• Confidentiality & Privacy
• Termination & Notice Requirements
• Additional Care Terms
• Caregiver Signature
• Client / Patient or Authorized Representative Signature

The template is a two-page agreement and includes customizable PDF and Word files.

PERFECT FOR
• Independent Caregivers
• Home Care Providers
• Personal Care Providers
• Senior Care Services
• Elder Care Providers
• In-Home Caregivers
• Companion Care Providers
• Private Duty Caregivers
• Home Health Professionals
• Caregiver Businesses
• Families Hiring In-Home Care
• Personal Assistance Services
ESTABLISH CLEAR CAREGIVING EXPECTATIONS
A written caregiver agreement gives both parties a central document outlining the services and expectations of the caregiving arrangement.
Use this template to help:

✓ Define the caregiver’s scope of services
✓ Identify included and excluded care tasks
✓ Establish days and hours of service
✓ Document compensation and payment frequency
✓ Establish holiday and overtime rates
✓ Record caregiver qualifications
✓ Document authorized home access
✓ Identify emergency contacts
✓ Record physician and authorized representative information
✓ Establish confidentiality expectations
✓ Document termination requirements
✓ Obtain signatures from both parties

DEFINE THE SCOPE OF HOME CARE SERVICES
Clearly document what services the caregiver will and will not provide.
Customize the agreement for services such as:

• Personal Care Assistance
• Companionship
• Meal Preparation
• Light Household Assistance
• Mobility Assistance
• Transportation Assistance
• Appointment Support
• Daily Living Assistance
• Senior Support Services
• Other Agreed-Upon Caregiving Tasks

Only include services that the caregiver is appropriately qualified and legally permitted to provide.

COMPENSATION & CARE SCHEDULE
Establish important financial and scheduling terms before services begin.
The agreement provides space for documenting the care schedule, base compensation rate, payment frequency, holiday rates, overtime rates, and termination notice requirements.

EMERGENCY & HOME ACCESS INFORMATION
Caregiving arrangements may require access to a client’s home and important emergency information.
Use the template to document:

• Authorized areas of the home
• Keys or access codes provided
• Emergency contacts
• Primary physician information
• Authorized decision-maker information
• Other important care-related contacts

CUSTOMIZABLE FOR YOUR CARE ARRANGEMENT
Personalize the agreement with your:
• Caregiver or business name
• Client information
• Contact information
• Care schedule
• Scope of services
• Excluded services
• Compensation rate
• Holiday and overtime rates
• Emergency contacts
• Home access information
• Termination requirements
• Additional care-specific terms

DIGITAL DOWNLOAD
This is a digital product. No physical item will be shipped.
Your purchase includes PDF and Word document formats for convenient customization and printing.

After purchase, download your files, customize the applicable sections for your caregiving arrangement, and print or save the completed agreement as needed.

IMPORTANT DISCLAIMER
This template is provided for general informational and document-preparation purposes only and does not constitute legal, medical, employment, tax, licensing, privacy, or regulatory advice.
Caregiver licensing, employment classification, wages, overtime, scope of practice, privacy, medical decision-making, insurance, and home care requirements may vary by state, jurisdiction, and type of services provided.

This agreement does not authorize a caregiver to perform medical services, make healthcare decisions, or perform tasks outside their applicable training, license, certification, or legal scope of practice.

Buyers are responsible for reviewing and customizing the agreement for their specific caregiving arrangement and applicable requirements. Consider having the completed agreement reviewed by an appropriate legal or healthcare professional before use.

Due to the nature of digital products, all sales are final.