# Caregiver Agreement Template

> A free caregiver agreement template for families and care agencies. Caregivers add their details, duties and schedule, read the terms, and sign online.

A caregiver agreement with ready terms for duties, hours, pay, time records, privacy and notice. The caregiver adds who they care for, the schedule and duties, uploads any certifications, then signs, and you keep a signed PDF.

Canonical: https://reuily.com/templates/caregiver-agreement
Use this template: https://reuily.com/form/from-template/caregiver-agreement
Collections: Agreements & Waivers, Home & Senior Care
Last updated: 2026-10-24

## Questions

- Question 1: What's your full name? (Short Text, required)
- Question 2: What's your email address? (Email, required)
- Question 3: What's your phone number? (Phone, required)
- Question 4: What's your home address? (Short Text, required)
- Question 5: Who will you care for? (Short Text, required)
- Question 6: When do you start? (Date, required)
- Question 7: What's your regular schedule? (Short Text, required)
- Question 8: Which duties are included? (Multiple Choice, required). Options: Companionship; Bathing, dressing and grooming; Meals; Medication reminders; Light housekeeping and laundry; Transportation and errands; Overnight care
- Question 9: Upload any caregiving certifications (File, optional)
- Agreement: Caregiver agreement, accepted with "I agree" (full text below)
- Question 10: Sign the caregiver agreement (Signature, required)

Signing records the signer's consent, email, IP address, browser and signing time, and each signer can download a signed PDF copy.

## Caregiver agreement

Please read this before you sign.

This agreement is between **[Family or agency name]** (the "Client") and the caregiver named in this form.

1. **Duties.** The caregiver provides the care chosen above. Medical tasks such as giving injections are not included unless the caregiver is licensed and the Client agrees in writing.
2. **Schedule.** The caregiver works the schedule above. Changes need **[number]** days notice from either side, except in an emergency.
3. **Pay.** The Client pays **[hourly rate]** per hour, paid **[weekly or every 2 weeks]**. Overtime and holidays are paid as **[state]** law requires.
4. **Time records.** The caregiver keeps a record of hours worked and care given, shared with the Client each **[week]**.
5. **Privacy.** The caregiver keeps the care recipient's health, finances and home private, during and after this agreement.
6. **Emergencies.** In an emergency the caregiver calls 911 first, then the Client.
7. **Ending.** Either side may end this agreement with **[number]** days written notice, or right away for serious misconduct.

By signing below, I confirm that I have read this agreement and agree to it.

## Common uses

- Families hiring a private caregiver
- Home care agencies placing caregivers
- Live in and overnight care

## Key features

- Duties and schedule
- Pay, notice and privacy terms
- Signed PDF for every caregiver

## Frequently asked questions

### What should a caregiver agreement include?

Duties, schedule, pay rate, overtime, time records, privacy, emergencies and how to end it. This template includes each of them.

### Can families use it for a relative who gives care?

Yes. Families often use a caregiver agreement when paying a relative. Check tax and benefit rules in your state before you rely on it.

### Is the caregiver an employee or a contractor?

That depends on your state and how the work is set up. The template is a sample to start from, not legal advice.