What is a home care services agreement?
When a family brings in a home care agency, both sides need the same picture: which tasks the caregivers do and which they don't, how visits are scheduled and covered, what an hour costs, and how either side can end it. This agreement is written for non-medical care, such as personal care, companionship, meals, housekeeping and medication reminders. It says plainly that caregivers do not provide nursing.
You list the services and the visit schedule and choose how often the care plan is reviewed. Set the hourly rate, the minimum hours per visit and the billing cycle, with optional premium, live-in and mileage rates. The client agrees to keep the home safe and share health information. Cancellation notice, an optional no-hire clause with a placement fee, and notice to end are all yours to set. If a family member signs for a parent, name the person receiving care and the wording adjusts.
- Best for
- Home care agencies providing personal care, companion or respite care
- Signed by
- The agency and the client or the family member who arranges care
- Rates
- Hourly with a visit minimum, plus optional premium, live-in and mileage rates
- Length
- About 3 pages, initialled on every page
When to use a home care services agreement
- An adult child arranging weekday care for a parent living alone
- Short-term care at home after a hospital stay
- Respite visits so a family caregiver can take a break
- Live-in companion care for an older person
- An agency standardising its client contracts
What you fill in
25 blanks, then the name and email of each person who signs: agency, client.
1 The parties
- Services start on*
- Agency (your business)*
- Agency licence or registration (optional)
- Agency office phone and email*
- After-hours contact (optional)
- Client (person signing and paying)*
- Person receiving care, if not the client (optional)
- Address where care is given*
2 Care plan
- Services in the care plan*
- Visit schedule*
- Care plan reviewed every* month · 3 months · 6 months · 12 months
3 Rates and billing
- Currency*
- Standard hourly rate*
- Weekend, night or holiday rate (optional)
- When the premium rate applies (optional)
- Live-in daily rate (optional)
- Minimum hours per visit*
- Mileage for errands in the caregiver's car (optional)
- Billing* weekly in arrears · every two weeks in arrears · monthly in arrears · weekly in advance
- Days to pay an invoice*
4 Cancellations and ending
- Notice to cancel a visit without charge (hours)*
- Notice to end the agreement (days)*
- No-hire period after the agreement ends (months)
- Fee if a caregiver is hired directly (optional)
- Governing law*
5 Who signs
- Agency signature and date, job title, initials on every page · The home care agency providing the caregivers.
- Client signature and date, initials on every page · The person receiving care, or the family member or legal representative who signs for them and pays.
What the home care services agreement covers
- Non-medical care only
- The care plan
- Caregivers and substitutions
- Rates and billing
- Cancelling a visit
- The Client's home and safety
- Emergencies and incidents
- Privacy
- Ending the Agreement
- General
Using the home care services agreement, step by step
1 Name the parties
Enter the agency, the client who signs and pays, and the person receiving care if that is someone else, plus the care address.
2 Write the care plan summary
Edit the default list of services and enter the visit schedule. Choose how often the plan is reviewed.
3 Set rates and billing
Enter the hourly rate and visit minimum, any premium, live-in or mileage rate, the billing cycle and the days to pay.
4 Set notice and send
Choose the visit cancellation notice, the notice to end, and whether to include a no-hire period and placement fee. Then send it for signature.
Tips before you send it
- Many places license home care agencies and set rules on screening, training and contract terms. Check what applies where you work and add your licence number.
- Keep the detailed care plan as a separate document and review it whenever the client's health changes.
- No-hire clauses are restricted in some places. Leave the period blank if you're not sure it is allowed.
- File the signed agreement, the care plan and the emergency contacts in the client's folder so the family can find them.
Sign it online in minutes
- Fill in the blanks. Names, dates and amounts go straight into the agreement — the preview shows exactly where.
- Name who signs. Tick “This is me” for your own part. FileIt builds the PDF with every signature, date and initials box on the right line, and you can check or move anything before sending.
- Send it. Each signer gets a secure link and signs from any device — no account needed. The signed PDF, with an audit trail and a Certificate of Completion, is filed in your vault and emailed to everyone.
Home care services agreement: frequently asked questions
Does this cover nursing or medical care?
No. It is for non-medical home care. The agreement says caregivers will not give injections, change sterile dressings or adjust medication, and that medical care stays with the client's own doctors.
Can a family member sign for their parent?
Yes. Enter the parent as the person receiving care. The family member signs as the client and confirms they have authority to arrange and pay for care.
What is a no-hire clause?
A promise not to hire the agency's caregivers privately for a set time after the agreement ends, or to pay an agreed placement fee instead. It is optional. Leave the period blank to leave it out.
Is an electronic signature valid for a care agreement?
For an ordinary services contract like this, e-signatures are generally valid under laws such as the US ESIGN Act and UETA, eIDAS and UK law. FileIt keeps an audit trail and a Certificate of Completion.