• LOVING HEART HOME CARE LLC CLIENT AGREEMENT

  • Loving Heart Home Care LLC Agreement

    Email: info@lovinghearthomecare.net
    Phone Number: 313-74-9118
    Fax: 313-460-8345
    615 Griswold ST, Detroit, MI 48226 Suite 700

     

    Basic Information

    1.2  Parties Identification

    This home health care contract is entered into by and between the client and Loving Heart Home Care LLC, a service provider located at 615 Griswold ST, Detroit, Michigan 48226 Suite 700.

     

    Purpose of the Agreement

    The purpose of this document is to set out the basis under which the relationship between the parties will be conducted in relation to the service provided to the Client by Loving Heart Home Care LLC, including terms of service, conditions, limitations, and responsibilities.

     

    2. Agreement Between the Parties

    2.1 Explicit Authorization by the Client

    In acknowledgment of the preceding discussions and shared information, the undersigned parties mutually agree to the following terms:

    The Client grants explicit authorization to Loving Heart Home Care LLC, hereinafter referred to as the Service Provider, to deliver home health care services. The designated services will be conducted within the specified hours,  and administered by the assigned caregiver.
     

    Term

    The authority granted within this document for the provision of Home Health Care Services by Loving Heart Home Care LLC is effective from (Date Specified) and shall persist for the agreed-upon duration of (Time Specified). Should either party choose to terminate this agreement, a notice period of 30 days will be required.

    Service Provider Employee Information

    To provide assurance, Loving Heart Home Care LLC affirms that it possesses all necessary permits to conduct home health care activities in the state of Michigan, as indicated by license number. Additionally, the service provider certifies that its personnel, as mentioned above, are fully qualified to deliver home health care services. This qualification is granted under a license issued in the state of (State.EmployeeLicense), reflecting their training in nursing care and any requisite special training.

     

    3.  Provided Services

    The service provider shall be responsible for providing fully certified nursing care and nursing services for the care of the Client.

    Among the powers granted to the service provider are:

    Administration of the medications listed here:

    (Name.Medication)

    (Amount.Medication)

    (Hours.Medication)

    (SpecialMedication.Instructions)

    Provide medical treatment or care as required by the circumstances affecting the patient, including, but not limited to, doctor or hospital visits.


    To assist Client in maintaining his/her home and to enable him/her to perform as many of the tasks for which he/she is qualified around his/her home and life.

     

    4. Payment Agreement

    Should the client request additional services beyond the agreed-upon hours or holidays, an extra payment of (Payment.Amount) per hour is applicable. Furthermore, any essential or emergency expenses incurred by Loving Heart Home Care LLC to fulfill its obligations must be reimbursed by the client.

     


    5. Additional Clauses

    5.1 Confidentiality Clause

    Loving Heart Home Care LLC acknowledges the confidentiality of private information obtained during the course of providing services and pledges not to disclose such information. This confidentiality obligation extends beyond the termination of this contract.

    5.2 Force Majeure Clause

    In the event that the performance of activities outlined in this contract is impeded by causes beyond the control of either the client or Loving Heart Home Care LLC ("Force Majeure"), rendering the service provider unable to fulfill its duties, the service provider shall promptly notify the client. Consequently, the service provider's obligations will be suspended for the duration of the event, with extensions as necessary.

    Acts of Force Majeure contemplated in this document include (but are not limited to): epidemics, pandemics, health crises, acts of God, fires, vandalism, storms, medical supply failures, labor strikes, national emergencies, insurrections, riots, or war. The excused party must make reasonable efforts to overcome such situations and demonstrate the impossibility of doing so.

    5.3 Severability of the Contract

    In the event that any clause in this contract becomes null, invalid, or unenforceable, it shall not invalidate the entire document until the contract itself is terminated. The remaining clauses will continue to be effective as long as possible according to state laws.

    5.4 Notice Clause

    Any necessary notices or requests for communication may be issued in person or through electronic mail. In the case of legal proceedings, notices may be addressed to the parties' indicated addresses.

     

     

    6. Applicable Law

    This home health care contract template complies with and is governed by the laws of the state of Michigan. Any dispute resolution or arbitration must adhere to the laws of the state for resolution.

     

    7. Signing

    This agreement was signed by the parties on (Signing.FullDate) and shall be effective immediately upon such act.
     
     

  • PATIENT INFORMATION

    As a responsible party for this contract, the client's information is as follows:
  • EMERGENCY CONTACT INFORMATION

    In emergency situations, the service provider shall contact the following person:
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  • In the event that a client/patient is unable to write or sign the agreement, a parent/guardian shall sign the agreement on their behalf.

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