Customer Details:
We're excited to help your simplify caregiver recruiting and grow your agency! This page is to sign up for recurring monthly plans. Once your form is completed, you'll receive your full onboarding packet and a welcome from your account manager. Most customers are fully onboarded within 2-3 business days.
Company Name
*
First Name
*
Last Name
*
Office Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
How did you hear about us?
*
Other
Who referred you?
*
What conference?
What webinar?
What type of appointment will Carework be booking for you after we screen each applicant?
Interview Bookings
Orientation Bookings
Carework Subscription
*
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( X )
Executive Plan + Onboarding Fee
(
$
3,709.00
for
1 month
)
Advanced Plan + Onboarding Fee
(
$
2,609.00
for
1 month
)
Basic Plan + Onboarding Fee
(
$
1,729.00
for
1 month
)
I agree that the payment method I use today will be the default for all future billing. Any payment made by credit card, debit card, Amazon Pay, Cash App or Link will incur a 2.9% processing fee. Payments made directly from a bank account (ACH) will not have an additional fee.
*
I agree
I have read and agreed to the terms and conditions
*
I agree
I agree to be charged on a monthly subscription plus the initial onboarding fee as outlined above
*
I agree
Digital Signature for attached PDF Contract and Other Terms On This Page
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