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.
Application Caregiver Form With Decimals In Dallas
Category:
State:
Multi-State
County:
Dallas
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
In-home caregiver as a household employee Provide a completed Form I-9 to your household employer to ensure you're qualified to work in the U.S. Provide a completed W-4 form and state income tax withholding forms. Complete your federal income tax return using Form W-2, which will be provided by your employer.