Terms & Form of Payment Guarantee

Terms & Form of Payment Information
Quoted Rate from CareChamp - valid for one month from date of Terms Signed.
Once-off & Weekly Estimate ; +Deposit information. Initial Deposit Invoice will be generated and debited after signing T&Cs. Weekly Invoices will be generated as per actual care delivered every Thursday & debited every Friday. OR you have the choice of a MONTHLY UPFRONT PAYMENT PACKAGE where no deposit invoice applies (not for half day packages & < than 5 days/week).
Date of Terms

DayMonthYear
Date
Name of Care Recipient*

First NameLast Name
ID Number of Care Recipient
Medical Aid Name, Plan and Membership Number of Care Recipient
Very Important to have for potential Emergency Call-Out. Also relevant if we can assist claiming through medical aid directly.
Your Details
Please choose your preferred mode of billing / payment. [In case of a medical aid authorisation only a potential co-payment (if not fully covered) will be billed directly to you.]*

Weekly Bank Account Debit based on prior 7 days services delivered (NO ADMIN for you)Weekly Cheque / Credit Card Debit based on prior 7 days services delivered (NO ADMIN for you)Monthly ongoing (or once-off for limited timeframe) Upfront Payment via EFT - for estimated services for the month which will be reconciled against actual services delivered.I have paid via the CareChamp Store
Debit Order Mandate

I hereby declare giving authority to debit the subsequent account weekly for the bookings completed through CareChamp for the 7 days prior to debit date. The weekly debit amounts might vary slightly according to bookings made - and always be in line with Invoices issued on a weekly basis. Should there be any credits to be made, they will be applied and visible in the monthly statement sent and applied to subsequent open invoice(s). CareChamp uses Netcash to process debits from bank accounts and Stripe to process debits from Cheque / Credit Cards. CareChamp confirms that payment details are stored safely and securely via Netcash and Stripe Encryption services. Once services end - payment details will be deleted. Any related fees are being absorbed by CareChamp.
Given By (Name of Bank Account Holder)*

First NameLast Name
Name of Bank*
Branch Code
Name of Bank
Bank Account Number*
(Not Debit or Credit Card number, but actual bank account number pls)
Type of Account*

Current / ChequeSavingsTransmission
Branch Number

Cheque / Credit Card Mandate*

CareChamp Services

1ZAR Quantity

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Signed at Place* on Date* .

Are you interested in any of the following add-on services that we can provide via our team & partners? Any of the "shopping & delivery services" as well as the "deep cleaning" are charged at Cost Price + R59 service charge per order.

	YES	NO	Tell me More
Grocery Shopping & Delivery for the Client
Personal Care (such as Adult Diapers f.ex.) Shopping & Delivery for the Client
Deep Cleaning Services for the Client
Grocery Shopping for Live-In Caregiver Champ @R50/day - in cases where food cannot be easily provided for your allocated Champ (such as family living overseas)
Quarterly Registered Nurse Visits for Health Checkins and Consultations @R550 / visit.

Assisted by: CareChamp Care Manager

FOR OFFICE USE
Signature (as used for operating on the account)*

Clear

THE SERVICES - CLICK TO READ
THE SERVICES

The Client requested that CareChamp provide The Client with Care Services through independent care providers to the Client at the Client's Venue of Choice.

The Services constitute a recruitment service and technology platform that enables users of CareChamp’s website and mobile application provided as part of the Services to arrange, schedule and pay for caregiving services of independent third party providers of such services, including independent third party caregiving providers under agreement with CareChamp.

Whilst CareChamp provides back office support and sources qualified and vetted Caregivers to the best of our abilities, the client acknowledges that caregiving and/or nursing services are provided by Independent third party contractors.

Required Services from Care Provider for Client: As per agreed Care Plan.

Here more details on the different offerings

WHAT CAREGIVERS DO: https://www.carechamp.co.za/caregivers

WHAT COMPANION CARERS DO: https://www.carechamp.co.za/elderly-companion-care-services

WHAT REGISTERED NURSES DO: https://www.carechamp.co.za/nurses

All our Caregivers are covered by Workman's Compensation, hence should anything happen to them at their place of work, CareChamp Homecare will take responsibility for the process to initiate with the Department of Labor for claiming Workmans Compensation.

We also have medical malpractice insurance in place.

Notice Period: we require 72 hours notice period to terminate our services or change any services within your booking as CareChamps are reserved in advance.

Agreed Process:

An Office Agent will be allocated to you and be your main point of contact for any administrative matters and assistance.
Depending on the length of the booking,CareChamp will assist sourcing the required amount of care providers.
ONLY Where medical attention at home is required: Our Registered Nurse will conduct an initial home nurse assessment, caregiver onboarding and care plan report at R599 (might be partially or fully covered by Medical Aid in case of an authorisation) and R99 transportation per caregiver who is not booked to stay immediately for the day. The assessment fee is FREE OF CHARGE in case of bookings that are longer than 1 month.
Depending on the length of the booking and the medical requirements our Registered Nurse will conduct a standard quarterly medical checkup & progress report at R550.(might be partially or fully covered by Medical Aid in case of an authorisation).

When the Caregivers are placed, a rotating schedule is agreed between CareChamp and The Client – which CareChamp will manage.
Our Caregiver Champs write reports via their smartphones back to us which we compile and provide you with on a weekly basis, so they are advised at the end of their shifts to document their day's activities with your loved ones on their phone. Please allow them 10 minutes time for this.

CareChamp Office Team will provide The Client with weekly status and work reports.

The Caregivers are responsible for their own transport.

Food will please need to be provided by The Client (except for half day bookings). The CareChamp Office can organise a food order delivery for R75 / day food budget. The client agrees that the Caregiver to take their meal intervals, i.e. lunch and/or tea break for approximately 15 minutes: in an area close to their client reach,where the Caregiver is able to have full view of their client in an area that the client is comfortable with ; when their client is also having their meal, i.e. breakfast, lunch and tea break.

We please ask you to refrain from discussing administrative matters with Caregivers - due to this causing sometimes unclarity in terms of reporting lines or miscommunication. Should a Caregiver approach you, please mention to discuss all matters with the CareChamp office. Should you as our client have a question for us, we are 100% transparent and can share details with you.

RATES AND INVOICING - CLICK TO READ
RATES AND INVOICING

PRIVATELY PAYING

The Client will receive an initial once-off invoice for the first week of services upfront, which will need to be paid via debit/credit card (a secure payment link will be provided on the invoice) after signing the T&Cs. Payment must be made before services commence.

Subsequently The Client will be invoiced weekly according to the hours booked and completed on the weekly time schedule at the agreed upon rates.

For weekly debits:Invoices will be debited one business day after presentation. CareChamp invoices for services consumed on a weekly basis. Both Debit or Credit order mandate options are available.

For monthly upfront EFT payments: weekly invoices will be reconciled against estimated upfront deposit amount held.

The yearly escalation rate of agreed upon fees will be at CPI or 6% (whichever is greater).

When driving is required as a task with the Caregiver’s own car - R4.84/km fee will be charged to get the client to and from appointments.

RISK SURCHARGE of 20% in case of a highly transmittable disease such as Covid-19 or TB due to post-placement isolation of caregiver required + additional fees for protective equipment at cost.

MEDICAL AID FUNDED

Please note that in case of a Medical Aid Authorisation for home based care (usually post-op care, palliative care and very rarely frail care), the invoices might get settled straight via the Medical Aid, in which case no payment might be required from the client.

A Medical Aid authorisation clearly outlines the period (timeframe) of the valid authorisation as well as the funds available. Our agency is able to assist in evaluating eligibility based on the client's clinical condition & medical aid plan. Please read more here on known plans covering different Care requirements in your own home.(https://www.carechamp.co.za/care-for-medical-aid)

If authorisation is received at a later stage for Care that was already delivered in privately paid capacity, we are only able to apply the authorisation from the beginning of the month that the authorisation was received (not for prior months).

Should the client apply directly / liaise directly for Authorization from their Medical Aid for Home Care, the client would need to pay CareChamp directly and claim back from Medical Aid. If the client follows CareChamp's process and the agency applies directly to medical aid for homecare - in case of authorisation - the medical aid will settle the account directly with the agency.

TERMS FOR PLACEMENT REFERRAL:

Should you wish to make a direct employment offer to one of our CareChamp candidates (including after a trial or introduction arranged by us), CareChamp charges a once-off placement fee based on the estimated annual salary of the role.

Our placement fee ranges between 8% – 10% of the agreed annual base salary, depending on the nature of the role and hours required.

TERMS AND INDEMNITY - CLICK TO READ
CONTRACTUAL RELATIONSHIP

These Terms of Use (“Terms”) govern the access or use by The Client, an individual or company from South Africa, of products, and services (the “Services'') made available by CareChamp (Pty) Ltd, a private limited liability company established in South Africa, having its offices at CareChamp, Office F3, 155 Loop Street, 8001 Cape Town. Registration Number: 2021/149040/07

The Client’s access and use of the Services constitutes The Client’s agreement to be bound by these Terms, which establishes a contractual relationship between The Client and CareChamp. Supplemental terms may apply to certain Services, such as policies for a particular event, activity or promotion, and such supplemental terms will be disclosed to The Client in connection with the applicable Services. Supplemental terms are in addition to, and shall be deemed a part of, the Terms for the purposes of the applicable Services. Supplemental terms shall prevail over these Terms in the event of a conflict with respect to the applicable Services.

CareChamp’s collection and use of personal information in connection with the Services is as provided in the Privacy Policy located here (http://www.carechamp.co.za/privacy-policy/). CareChamp may provide to a claims processor or an insurer any necessary information (including The Client’s contact information) if there is a complaint, dispute or conflict, which may include an accident, involving The Client and a Third Party Provider (including a caregiver) and such information or data is necessary to resolve the complaint, dispute or conflict.

INDEMNITY

The Client hereby agrees that CareChamp (as well as its successors-in-title and assigns), its agents, representatives, independent contractors and employees or anyone else involved in providing the Services (collectively, the “Indemnified Parties”, and each an “Indemnified Party”) shall not be liable (under any circumstances whatsoever) for any direct, indirect, incidental, special or consequential damages related to, in connection with, or otherwise arising from any of the Services (howsoever arising).

The Client acknowledges that the Services requested are the services which shall be provided. CareChamp shall not be liable for any damages related to, in connection with, or otherwise arising from any service provided to The Client by any Indemnified Party which is requested, arranged or otherwise agreed to with that Indemnified Party.

The Client hereby agrees to indemnify and hold harmless the Indemnified Parties, against any and all claims, demands, loss or damage, including (without limitation) financial loss, liabilities and expenses (including attorney’s fees on the scale as between attorney and client) arising out of or in connection with the Services.
AMOUNT: this will vary depending on services consumed and invoiced for on a weekly basis.
To (Name of Beneficiary): CARE CHAMP
Abbreviated Shortname to be used: CARE CHAMP
Refer to contract reference: CareChamp_{typeA12} (“the Contract Reference”)
A. TERMS

Refer to the contract in place with CareChamp Homecare (Pty) Ltd for rendering Care Services.
I/We hereby authorise Netcash (Pty) Ltd for bank account debit order OR Stripe for Credit/ Cheque Cards to issue and deliver payment instructions to your banker for collection against my/our abovementioned account at my/our above mentioned bank on condition that the sum of such payment instructions will not differ from my/our obligations as agreed to in the Contract Reference Number.
The individual payment instructions so authorised must be issued and delivered on the date when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not differ as agreed to in terms of the Agreement.
The payment instructions so authorised to be issued must carry the Contract Reference [CareChamp_INV_Number], included in the said payment instructions, and must be provided to identify the specific contract.
I /we agree that the first payment instruction will be issued and delivered on the first business day after initial deposit invoice and thereafter regularly every Friday for the week passed.
If however, the date of the payment instruction falls on a non-processing day (weekend or public holiday) I agree that the payment instruction may be debited against my account on the prior business day;
Subsequent payment instructions will continue to be delivered in terms of this authority until the obligations in terms of the Agreement have been paid or until this authority is cancelled by me/us by giving you notice in writing of not less than the interval (as indicated in the previous clause) and sent by prepaid registered post or delivered to your address indicated above.

B. MANDATE

I/we acknowledge that all payment instructions issued by you will be treated by my/our abovementioned bank as if the instructions had been issued by me/ us personally.

C. CANCELLATION
I/we agree that although this authority and mandate may be cancelled by me/us, such cancellation will not cancel the Agreement. I/we also understand that I/we cannot reclaim amounts, which have been withdrawn from my/our account (paid) in terms of this authority and mandate if such amounts were legally owing to you.
Should be Empty:

Terms & Form of Payment Information

Debit Order Mandate

THE SERVICES

Agreed Process: