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Caregiver Agreement Fill out the template

Caregiver Agreement

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Last revision
Last revision 12/14/2020
Formats Word and PDF
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Size 3 to 4 pages
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Last revision: 12/14/2020

Size: 3 to 4 pages

Available formats: Word and PDF

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Caregiver Agreement

A Caregiver Agreement is a document between a caregiver and a client, or (more often) a caregiver and a guardian for a client, in which the caregiver agrees to provide specific, defined caregiving services to the client. These documents are most often used for elder care, when a guardian of someone that can no longer take care of themselves hires a caregiver to assist in the day-to-day needs of the elderly person. These documents can also be used in situations where it is a member of the family deciding to take on the caregiving duties: in that case, it's a good idea to have all of the terms and conditions between the family members written down. It can also help if there are multiple adult children and just one will be taking care of elderly parents.

This agreement contains space for all the specific details for the caregiving services, as well as standard contractual provisions, as needed: things like a severability provision and governing law provision.

Importantly, the document also contains a confidentiality clause, making clear that the caregiver is supposed to keep the details of the client's life confidential. Such a clause can be especially important when the client may be sick.


How to use this document

This document should be filled out by the parties when they've agreed to the terms of the caregiving relationship between them. This document will ask specific questions about what the caregiving services will include. Therefore, it's a good idea to ensure the parties have discussed the details beforehand.

Either the caregiver or the client or guardian can fill out this document. Generally, as mentioned above, it's more common for a guardian to be contracting on behalf of a client for the caregiving services, so it is less likely the client will be doing it themselves.

First, the general party details are asked about, such as who they are, whether the client is under a guardianship, and their contact information. Then, additional questions are asked about the actual caregiving services, including what they will be, the fees, the schedule, and the living arrangements.

When this document is filled out, it should be signed by either the guardian and caregiver (more common) or the client and caregiver, and then have each keep a copy.


Applicable law

There is a federal model act called The Caregiver Advise, Record, Enable (CARE) Act. This law has been adopted by 39 different states. It allows support for family caregivers when their loved ones are admitted to a hospital and also helps family caregivers learn how to take care of their loved ones at home. Besides the CARE Act, laws vary per individual state regarding caregivers, including such laws as whether they are permitted to be paid by Medicare and whether unemployment insurance can cover family caregivers.


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