Driver's Agreement Form

Homewatch CareGivers of South Orange will pay hourly caregivers that agree to take assignments which include driving clients upon request on a ‘driver wage scale’. To be eligible for this ‘driver wage scale’ a caregiver must agree to the following requirements: (Please check each item below)

Name

First NameLast Name

Caregiver Driving Requirements *

	I acknowledge
Caregiver must have and maintain a clean, reliable, vehicle.
Caregiver must have a current registration.
Caregiver must have and maintain auto insurance.
Caregiver must have and maintain a current drivers’ license..
Caregiver is responsible to insure that current registration, current drivers’ license and current insurance info have been provided to Homewatch CareGivers.
Caregiver must have and maintain a satisfactory driving record which meets the requirements of the Homewatch CareGivers insurance provider.
Caregiver must be willing to accept cases which require local driving.
Caregiver must be willing to drive clients within a ten mile radius upon client request.
Vehicle must be available for inspection by Homewatch CareGivers management upon request.

I agree to the conditions stipulated above. I understand that I may be removed from the driver wage scale at any time if the conditions above are not met.

Signature*

Date