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.
Caregiver Form Sample With Name In Suffolk
Category:
State:
Multi-State
County:
Suffolk
Control #:
US-00458BG
Format:
Word;
Rich Text
Instant download
Description
Free preview
Form popularity
FAQ
Income Requirements Family SizeAnnual Income LimitMonthly Income Limit 2 $73,869.56 $6,155.80 3 $91,250.63 $7,604.22 4 $108,631.70 $9,052.64 5 $126,012.77 $10,501.062 more rows
Who Can Apply for a Child Care Voucher? Your family may qualify for child care assistance if your family's income falls below 85% of the State Median Income and you have an approved reason for seeking child care ("reason for care"). This reason must be at least one of the following: You work 10+ hours per week.
Get Help Applying for SNAP Family SizeMonthly Gross IncomeAnnual Gross Income 1 $2,510 $30,120 2 $3,407 $40,884 3 $4,303 $51,636 4 $5,200 $62,4005 more rows