Bold = Required field

This agreement is made and entered into on

This agreement is between (caregiver)

and      (family)

During the term of this Agreement, Caregiver will perform a non-nursing service requested by Family. The service and advice will relate to work being done or planned by family and caregiver in the field of

and will be within the area of Caregiver's technical competence. The Caregiver is in accordance with Family's specific objectives and goals outlined in the Family Placement Order form, but not limited to, which may include the following:

Caregiver's services shall commence with Family from

to

This agreement can be terminated by Family or Caregiver, however, both parties should provide 14 days written or oral notice.
 
Compensation for all services rendered by Caregiver:
 
A. Family agrees to pay the Caregiver a base salary of

B. Caregiver will be paid every (week /weeks)

C. Overtime compensation is paid at an hourly rate of (per hour)

D. Details of vacation time / paid or unpaid:

E. Details of Holidays / paid or unpaid:

F. Details of Personal / Sick Days / paid or unpaid:

I am the principal:

Type your full name