Hire God’s Heart HHC

This Home Health Care Contract is entered between ________________ (Client), _________, ___________, Arizona _____ and God’s Heart Home Health Care LLC (the Service Provider), 10802 N 16th Ave, 4, Phoenix, Arizona 85029. The Client and the Service Provider shall be collectively known herein as the Parties.
WHEREAS, the purpose of this Contract is to set out the terms of services to be provided to _________________ by Service Provider generally known as “God’s Heart Home Health Care,” IN Consideration of the mutual promises and other valuable consideration exchanged, the Parties hereby agree and contract as follows:

  1. AUTHORIZATION. The Client hereby grants the authority to the Service Provider to provide Home Healthcare Services to ____________ at _________________’s home located at ___________, ____________, _________ _____.
  2. TERM. This grant of authorization to provide Home Healthcare Services shall begin on ________________, and shall remain effective for a period of __________ weeks/months/years. This Contract may be terminated prior to this term by either party on giving a written notice of ___ days.
  3. LICENSING. The Service Provider warrants that, Service Provider is licensed in the state of Arizona to provide the services mentioned in this Contract. Further, any employee or representative of the Service Provider performing services under this Contract is licensed in the state of Arizona as a Certified Nursing Assistance and is current on all training and certifications.
  4. DESCRIPTION OF SERVICES. The Service Provider shall provide a Certified Nursing Assistant to attend _________________________.
    The Certified Nursing Assistant provided by the Service Provider shall have the power to:
  • Administer medications as follows:
    Name of medication: _____
    Amount to be given: _____
    Time to be given: _____
    Other instructions: PER PATIENTS PRESCRIPTIONS
    Name of medication: _____
    Amount to be given: _____
    Time to be given: _____
    Other instructions: PER PATIENTS PRESCRIPTIONS
    Name of medication: _____
    Amount to be given: _____
    Time to be given: ____
    Other instructions: PER PATIENTS PRESCRIPTIONS
  • Strict Adherence To Doctors/Physicians Orders.
  • Service Provider or its representative will assist ____________ to live at home and to have as much control over the home environment and life as possible.
  • Seek appropriate medical treatment or attention on behalf of as may be required by the circumstances, including but not limited to, medical doctor and/or hospital visits.
  • Make appropriate decisions regarding clothing, bodily nourishment, and shelter.

Apart from performing above tasks the Service Provider shall do similar related tasks to be mutually agreed upon by the parties.

5. CONTACT PERSONS. The Client’s contact information is as follows:

Name: __________________
Address: _______________ _____, ____ ______ Phone Number: _________________

Relationship to _________________: _____

In an emergency situation, the Service Provider should immediately contact the following person:

Name: ____________________ Phone Number: _________________
Address: _________________ ____________, _____ _____

If that person is not available, please contact the following alternate choice:

Name: __________________

Phone Number: __________________ Address: ______________________

6. PAYMENT . The Client shall pay a monthly contract price to the Service Provider at an amount of $_____________.

The monthly fee constitutes payment for all services performed during the Service Providers
normal working hours which are defined as follows:

  • Monday: _____
  • Tuesday: _____
  • Wednesday: _____
  • Thursday: _____
  • Friday: _____
  • Saturday: _____
  • Sunday: _____

If any additional service is done outside the working hours or on holidays, the Client shall pay $_________ per hour to the Service Provider as additional payment. The amount of compensation to be paid to the Service Provider for the Services in this Contract shall be covered by the Client.

7. CONFIDENTIALITY. Service Provider understands that any and all private information obtained about the Client, Client’s family, _____, _____‘s family or relatives during the course of employment, including but not limited to medical, financial, legal, career and assets are strictly confidential and may not be disclosed to any third party for any reason. The obligations of the Service Provider under this clause survive termination of this Contract. God’s Heart Home Health Care Requires Strict adherence to all HIPAA regulations.

8. FORCE MAJEURE. If performance of this Contract or any obligation under this Contract is prevented, restricted, or interfered with by causes beyond either party’s reasonable control (“Force Majeure”), and if the party unable to carry out its obligations gives the other party prompt
written notice of such event, then the obligations of the party invoking this provision shall be suspended to the extent necessary by such event. An occurrence of Force Majeure shall mean an occurrence beyond the control and without the fault or negligence of the party affected and which by exercise or reasonable diligence the said party is unable to prevent or provide against. Without limiting the generality of the foregoing, force majeure occurrences shall include: acts of foreign
combatants, terrorist acts, military or other usurped political power or confiscation, nationalization, government sanction or embargo, labor disputes of third parties to this contract, or the prolonged failure of electricity or other vital utility service. Any party asserting Force Majeure as an excuse to performance shall have the burden of proving proximate cause, that reasonable steps were taken to minimize the delay and damages caused by events when known, and that the other party was timely notified of the likelihood or actual occurrence which is claimed as grounds for a defense under this clause.

9. SEVERABILITY. In the event any provision of this Contract is deemed to be void, invalid or unenforceable, that provision shall be severed from the remainder of this Contract, so as not to cause the invalidity or unenforceability of the remainder of this Contract. All remaining provisions of this Contract shall then continue in full force and effect. If any provision shall be deemed invalid due to its scope or breadth, such provision shall be deemed valid to the extent of the scope and breadth permitted by law.

10. AMENDMENT. This Contract may be modified or amended in writing, if the writing is signed by the party obligated under the amendment.

12. NOTICE. Any notice or communication required or permitted under this Contract shall be sufficiently given if delivered in person or by certified mail, return receipt requested, to the address set forth in the opening paragraph or to such other address as one party may have furnished to the other in writing.

13. ATTORNEY’S FEES. In the event of any breach of this Contract, the party responsible for the breach agrees to pay reasonable attorneys’ fees and costs incurred by the other party in the enforcement of this Contract or suit for recovery of damages. The prevailing party in any suit instituted arising out of this Contract will be entitled to receive reasonable attorneys’ fees and costs incurred in such suit.

14. APPLICABLE LAW. This Contract shall be governed by the laws of the State of Arizona.

15. SIGNATURES. This Contract shall be signed by ____________________ and by Melissa Wilson, Owner/CEO of Melissa Wilson.

Dated: ____________________________
Client: _____________________________
Service Provider: ________________________

Melissa Wilson ______________________
Melissa Wilson, Owner/CEO