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Personal & Family Services

Senior / Elder Care Services Agreement

An agreement for a non-medical caregiver providing in-home support to a senior — scope of care, schedule, and emergency contacts.

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Free general-purpose template, not legal advice. Fill in the placeholders and consider having a lawyer review it before you rely on it.

1. Parties & Care Recipient

This Senior / Elder Care Services Agreement ("Agreement") is entered into as of [Effective Date] between [Family/Client Name] ("Client") and [Caregiver Name] ("Caregiver"), for the care of [Care Recipient Name].

2. Scope of Care Services

Caregiver will provide non-medical support services, including: [Services — e.g. companionship, meal preparation, light housekeeping, medication reminders, transportation]. This Agreement does not cover skilled nursing or medical care.

3. Schedule

Caregiver’s schedule is [Schedule], at [Location].

4. Compensation

Client agrees to pay Caregiver [Rate] per hour, paid [Frequency].

5. Emergency Contacts & Medical Authorization

In case of emergency, Caregiver will contact [Emergency Contact Name/Phone] and, if needed, call 911. Relevant medical conditions, medications, and physician contact are described in [Attachment].

6. Confidentiality

Caregiver agrees to keep the Care Recipient’s health and personal information confidential, sharing it only with those authorized in this Agreement or by Client.

7. Independent Contractor Relationship

Caregiver is an independent contractor, not an employee of Client, and is responsible for their own taxes, insurance, and any required certifications.

8. Termination

Either party may terminate this Agreement with [Number] days’ written notice, or immediately in the case of a safety concern.

9. Governing Law & Signatures

This Agreement is governed by the laws of the State of [State / Jurisdiction].

Caregiver Signature: _______________________ Date: _______________

Client Signature: _______________________ Date: _______________

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