This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
IHSS is the largest publicly funded home care program in the United States. IHSS helps to pay for services to eligible aged, blind and disabled individuals.Contra Costa Health Plan (CCHP) has been serving the health needs for people in the County for 40 years. CCHP was the first federally. CDPH 270 (PDF) Certification Form for Clinics and Freestanding Outpatient Clinic Services of a Hospital What forms do I need to get the order? You must fill out all of form.