Home Care Release of Liability

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I. Introduction

This Home Care Release of Liability ("Release") is made effective as of [Date], by and between [Home Care Provider Name], located at [Provider Address], hereinafter referred to as the "Provider," and [Client Name], residing at [Client Address], hereinafter referred to as the "Client."

II. Purpose

The main objective of this Release is to create a common understanding between two parties, the Provider and the Client. The understanding primarily pertains to the inherent risks that are typically involved in the provision and receiving of home care services. Additionally, its central goal is to define and highlight the duties, responsibilities, and potential liabilities held by each party involved in this type of agreement.

III. Acknowledgment of Risks

The Client acknowledges that receiving home care services at their residence involves inherent risks, including but not limited to:

• Accidental falls or injuries

  Acknowledges the possibility of the client experiencing slips, trips, or falls within their residence, which can lead to injuries such as fractures, bruises, or sprains.

• Allergic reactions to medications or treatments

  Recognizes that clients may have allergic reactions to prescribed medications, treatments, or materials used during home care services, potentially resulting in adverse health effects.

• Equipment malfunctions or failures

  Acknowledges that medical equipment or devices used during home care services may malfunction or fail unexpectedly, which could disrupt treatment or pose safety risks to the client.

• Unforeseen medical emergencies

  Acknowledges the unpredictable nature of medical emergencies that may arise despite precautions, such as sudden cardiac events, seizures, or other acute medical conditions requiring immediate attention and intervention.

IV. Release of Liability

In consideration of the services provided by the Provider, the Client hereby releases, waives, and discharges the Provider, its employees, agents, and representatives from any liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or harm suffered by the Client as a result of receiving home care services, except for cases of gross negligence or willful misconduct by the Provider.

V. Client Responsibilities

The Client agrees to:

• Provide accurate medical information: Clients agree to share complete and precise medical history for safe and tailored care.

• Follow provider instructions: Clients agree to follow prescribed care plans and safety guidelines for optimal outcomes.

• Report health changes promptly: Clients agree to inform providers promptly of any health changes for timely adjustments and continued safety.

VI. Provider's Responsibilities

The Provider agrees to:

1. Provide professional care: The provider delivers skilled and safe home care services.

2. Inform of risks: Provider communicates known hazards for informed decisions and safety awareness.

3. Maintain confidentiality: Provider keeps client health information private and complies with privacy laws.

VII. Indemnification

The Client agrees and expresses their consent to secure the Provider against any harm and exonerate them, including but not limited to their employees, agents, and representatives, from any declarations of damages, complaints, or liabilities that may arise as a consequence of the Client's failure to disclose certain medical information, that are germane and significant to the situation, or as a result of the Client's failure to comply with given instructions.

VIII. Governing Law

The legal interpretation, impact, and any potential issues stemming from this Release will be governed and completely understood in line with the current laws effective in [State/Country], regardless of any conflicting laws that might trigger the involvement of a different jurisdiction's laws.

IX. Entire Agreement

This Release is considered to be the comprehensive and complete agreement between the Provider and the Client concerning the content or subject matter included herein. It not only supersedes but also effectively replaces any prior agreements and understandings that might have been in place between the two parties. This stands whether these previous agreements and understandings were in written form, oral form, or any other mode of communication.

IN WITNESS WHEREOF, the parties hereto have executed this Home Care Release of Liability as of the date first above written.

[Home Care Provider Name]

[Client Name]

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Witness’s Signature (if applicable):

[WITNESS’S NAME]

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