Agreement for Home Health Care Services by pellcity27

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									                           Agreement for Home Health Care Services

        Agreement made on the (date), between (Name of Client) of (street address, city,
county, state, zip code), referred to herein as Client, and (Name of Nursing Agency), a
corporation organized and existing under the laws of the state of ______________, with its
principal office located at (street address, city, county, state, zip code), referred to herein as
Agency.

1.      Nursing Services and Rates
        Agency agrees to furnish Client with the services of a (certified nursing assistant or
registered nurse or nurse assistant) at the rate of $________ per hour and to also include
(number) cents per mile as well as $_______________ shift differential for shift changes as well
as $_____________ for a cancellation fee for services canceled with less than (number) hours
notice. Time and a half will be charged on the following holidays: (list holidays).

2.     Weekly Billing
       Agency will bill Client on a weekly basis and Client agrees that the work week will extend
from (day of week) to (day of week) from (time or day) to (time of day).

4.       Client Charges
         Client agrees to pay _________% interest per month on all amounts not paid within
(number) days of the statement. Client agrees to pay all reasonable attorneys' fees and court
costs in cases of col
								
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