This Senior Care Services Liability Waiver ("Waiver") is made and entered into as of [DATE] by and between:

  • [Your Business Name], a [State] [Business Structure (e.g., LLC, Corporation)], with its principal place of business at [Your Business Address] ("Company"), and
  • [Client Name], residing at [Client Address] ("Client"), and
  • **[Name of Guardian/Conservator (if applicable)], residing at [Guardian/Conservator Address] ("Guardian/Conservator") (collectively, "Client").

WHEREAS, Company provides non-medical senior care services (the "Services") to Clients; and

WHEREAS, Client desires to engage Company to provide the Services; and

WHEREAS, Company desires to limit its liability for certain matters related to the Services.

NOW, THEREFORE, in consideration of the foregoing premises and the mutual covenants contained herein, the parties agree as follows:

1. Services:

The Services include, but are not limited to:

  • Companionship
  • Assistance with daily living activities (ADLs) such as bathing, dressing, and grooming (Note: If offering medical services, consult with an attorney to ensure compliance with state regulations)
  • Meal preparation and assistance
  • Light housekeeping
  • Medication reminders (Note: Some states may have restrictions on medication management. Consult with an attorney)
  • Transportation to appointments (Note: Ensure you have proper insurance coverage for transportation)

2. Release of Liability:

Client acknowledges and agrees that the Services are non-medical in nature and do not constitute medical care or treatment. Client further acknowledges and agrees to the following:

  • Client Responsibility: Client is responsible for the safety and well-being of themself or the Client (if Guardian/Conservator is signing).
  • Assumption of Risk: Client assumes all risks inherent in the Services, including but not limited to the risk of falls, injuries, and property damage.
  • Release of Claims: Client, on behalf of themself, their heirs, assigns, and personal representatives, hereby releases and forever discharges Company, its officers, directors, employees, and agents (collectively, the "Released Parties") from any and all claims, demands, losses, liabilities, damages, and causes of action (collectively, "Claims") arising out of or in any way related to the Services, including but not limited to:
    • Personal injury or death of Client
    • Property damage of Client
    • Acts or omissions of Client
    • Acts or omissions of caregivers assigned by Company

3. Exceptions:

This Waiver does not apply to claims arising from the Released Parties' gross negligence, willful misconduct, or intentional fraud.

4. Medical Emergencies:

In the event of a medical emergency, Company will make reasonable efforts to contact emergency medical services. Client acknowledges that Company is not responsible for the outcome of any medical emergency.

5. Guardian/Conservator Consent:

If a Guardian/Conservator is signing this Waiver on behalf of Client, the Guardian/Conservator represents and warrants that they have the full right, power, and authority to enter into this Waiver on behalf of Client.

6. Governing Law:

This Waiver shall be governed by and construed in accordance with the laws of the State of [Your State].

7. Entire Agreement:

This Waiver constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior or contemporaneous communications, representations, or agreements, whether oral or written.

8. Severability:

If any provision of this Waiver is held to be invalid or unenforceable, such provision shall be struck and the remaining provisions shall remain in full force and effect.


[Client Signature]

[Printed Name of Client]


(Optional) Guardian/Conservator Signature

(Optional) Printed Name of Guardian/Conservator

(Optional) Date