Ontario_Client_Consent_Agreement_Arya_Healthy_Living_Inc_d_b_a_TheKey_Revised_per_TT_08_07_2024.txt

Client Name: [Account.Name]

Care Recipient (if different than client): [Care Recipient]

This Care Agreement (“Agreement”) is entered into on [effective date] (the “Effective Date”) by and between the aforementioned Client(s) and/or on behalf of the Care Recipient(s) (together referred to as “Client,” “you, “yours”) and Arya Healthy Living Inc. d/b/a TheKey (“Company,” “we,” “us,” “our”). The “Parties” are Company, Client, and Client’s Authorized Agent, if applicable, and, in the singular, refers to any of them, as the context makes apparent.. The care services (“Services”) will be provided at the below mentioned address. 

Address:

Street Name: _______________________________________________

City: ____________________________     Province: __________________________     Postal Code: ________________________

Home Phone: _______________________________________________

CONSENT TO RECEIVE SERVICES

We will dispatch “Caregiver(s)” to the residence or other facility identified by you for the provision of companionship services. We are hereby authorized to provide companionship services to you or the Care Recipient  through the use of such Caregivers. You understand that we are a non-medical agency that does not provide medical services or treatments. The Client acknowledges that the Client has authority of the Care Recipient (when one is listed above) to enter into this Agreement, and the Client waives any and all liability of the Company as it relates to medical services the Client may later allege that the Company should have provided, as we only provide non-medical services. A description of services to be performed is outlined as a part of the initial consultation. For more information on Caregiver scope of work, refer to Appendix A.

PLACEMENT FREE

We expend a significant investment of time, money and resources to recruit, screen, hire and train our employees, including our caregivers and nurses (collectively, “Caregivers”), to provide you with the best of care. Our Caregivers are prohibited from accepting private employment from you directly (or through another organization/agency) while they are working for us and for a period of three (3) years thereafter. If you wish to employ any of our Caregivers within this period, you agree to pay us a one-time placement fee of TWENTY-FIVE THOUSAND DOLLARS ($25,000.00) per Caregiver. We will charge this amount on your last invoice. Payment of such amount does not affect any liability or contractual obligations that the Caregiver may have toward Company.

____________ (INITIALS)  

STANDARD RATE

The Standard Rate applies unless your needs require the Complex Rate.

COMPLEX CARE RATE

A Complex Care Rate applies to clients with special needs or requests, including but not limited to (1) clients requiring full-body transfers, end-of-life care, delegated care, couples care, client behavioral issues, including those related to dementia and other diseases impacting mood/behavior; advanced medication requests, and other complex situations; (2) clients requiring shifts below six (6) hours and/or only shifts on weekends/nights; (3) locations requiring extensive driving/travel; and (4) other circumstances as determined by us. 

SUPPLIES

You are responsible for the payment of all required supplies in connection with Services, including but not limited to gloves, catheters, etc. The cost of supplies will be included in your regular invoices.

HOLIDAY AND OVERTIME RATES

We will charge one and one-half times (1.5x) the Billing Rate for Services provided on holidays. You can decline holiday service by notifying us at least seventy-two (72) hours in advance. Observed holidays are: New Year’s Day, Family Day, Good Friday, Victoria Day, Canada Day, Civic Day, Labour Day, Thanksgiving Day, Christmas Day, and Boxing Day.

We charge 1.5x the Billing Rate for overtime hours you receive Services in accordance with our overtime policy..

MILEAGE & PARKING REIMBURSEMENT

You agree to reimburse us for the automobile traveling and parking expenses incurred by Caregivers in the performance of their duties on your behalf that involve automobile travel. Duties include travel associated with Care Recipient appointments, running errands for the Care Recipient, etc. Traveling expenses do not include mileage to and from the location of care. The Caregiver will abide by all legal requirements relating to owning and operating a vehicle. We will invoice you at the current year’s reasonable mileage reimbursement rate as prescribed by the Canada Revenue Agency.

In the event the Caregiver uses the Client’s vehicle or the Care Recipient’s vehicle:

No mileage will be charged for such services

It is the Client’s exclusive responsibility to ensure vehicle insurance is up to date and allows for third parties to operate the vehicle. Furthermore, the Client warrants the vehicle is roadworthy.

ADDITIONAL SERVICE CHARGES 

Communicate any scheduling matters with your client/relationship manager as soon as possible. Do not alter, eliminate, or add schedules directly with your Caregiver. You may incur additional charges, including overtime (one and one-half times the Billing Rate) if you do not communicate your schedule change according to this policy. You are required to pay additional charges for non-scheduled hours of Services received, including working outside the scheduled shift, missed or interrupted break periods.

BILLING RATE CHANGES  

The rates listed above (“Billing Rates”) are subject to change, including due to an annual increase, change in your schedule or circumstances, change in Services requested, regulatory updates, market conditions, or Company-wide policy with at least three (3) weeks’ written notice or completion of a new Care Agreement. You may request an updated Care Agreement in the event of any Billing Rate change and we will not withhold one unreasonably, provided that your prior Care Agreement shall remain in effect until you execute the updated Care Agreement. You agree we will automatically charge you at the applicable Billing Rate. 

MEAL AND REST PERIODS

Caregivers are entitled to a thirty (30) minute break for every five (5) hours worked.

Live-In care is defined as a twenty-four (24) hour shift. Live-In Caregivers are entitled to receive four (4) hours of break time spread throughout the day for meals and personal time. All meals within reason are to be provided for the caregiver by the client. You understand that if a Caregiver has any special dietary restrictions or preferences that are not reasonable for you to adhere to, you are not obligated to do so. In general, however, you and Caregiver share the same meals. Live-In Caregivers are also entitled to one six (6) to eight (8)-hour block of uninterrupted sleep period every evening. During this period, the caregiver is not to be disturbed and is considered off-duty and must be provided with decent, private, and sanitary accommodations.

Unless otherwise agreed upon, or in the case of an emergency, the Caregiver will not leave your premises during a scheduled shift. You understand that circumstances beyond our control (e.g., Client or Caregiver short-term illness, change in Client sleep patterns, etc.) may require additional hours to be provided at the hourly rate specified above. Any additional service charges will be reflected on your regular invoice.

For shifts 24 hours in length, overtime is paid for hours worked in excess of 264 hours in a work month.

​CANCELLATIONS

Cancellations of scheduled shifts must be made during normal business hours for your designated Company office and more than forty-eight (48) hours prior to the start of the shift. Cancellations during non-business hours are recorded as of the next business day. Cancellations for weekend Services must be made by no later than the close of business the previous Friday. Cancellations not received within the timeframes provided herein will be subject to a cancellation fee equivalent to the Billing Rate for the entire scheduled shift.

 A Client who sends a Caregiver home before the end of their scheduled shift will be billed for the entire shift. 

CAREGIVER RISK OF PHYSICAL HARM

If there is an imminent risk of physical harm to one of our Caregivers in the course of Services, our Caregiver is entitled to vacate the premises without exposing themselves and/or us to liability. If the imminent risk of physical harm is caused by you or circumstances in your home, then we will charge for the shift even if the Caregiver does not complete it and this Agreement may be subject to immediate termination. 

SURVEILLANCE CAMERAS 

You must inform us of any surveillance cameras in your home prior to the starting of Services and at least one (1) restroom must be surveillance-free for use by our Caregivers. 

VALUABLES

You agree to secure and not entrust to Caregivers any valuables, including cash, jewelry, and confidential financial and personal information. You agree not to give any gifts, loans, bonuses, tips, payments, or advance any money to Caregivers without written authorization from us. 

EQUAL OPPORTUNITY EMPLOYER

We are an equal opportunity employer. We give equal opportunities to and do not discriminate against employees and applicants, including staffing matters, without regard to race, color, religion, sex, age, national origin, disability, and/or any other characteristic protected by law.  

LIMITATION OF LIABILITY

In recognition of the relative risks and benefits of services provided by Company, Client agrees to the fullest extent of the law, to limit the liability of Company for any and all claims, losses, costs, damages of any nature whatsoever or expense from any cause or causes, including attorneys’ fees and costs, and costs of expert witness fees and costs, so that the total aggregate liability of Company to the Client shall not exceed the total fees payable to Company for services rendered. It is intended that this limitation apply to any and all liability or cause of action however alleged or arising, unless otherwise prohibited by law. Further, Client releases Company from any claims for liability which the Client may acquire by reason of damage, loss, injury and/or suffering which arises from the operation and/or use of a vehicle by a Caregiver, whether that may be owned by the Client or a vehicle provided by the Caregiver or Company. In the event that the Care Recipient or any other person acting with the authority of the Care Recipient makes any claim against the Company, the Company may plead this Agreement and this Section as a complete defense, and the Client shall be responsible for indemnifying the Company for any losses or fees incurred. The Client also agrees not to hold Company liable for any intentional acts of Caregivers acting beyond the course and scope of their duties to provide companionship services, in which event a claim would be brought against the Caregiver directly.

FALL RISK DISCLAIMER

Clients of advanced age and/or conditions that cause physical instability or mental confusion are at elevated risk for falls. Our Care Providers understand these risks and are trained to minimize falls; however, you understand that the risk cannot be 100% eliminated. 

ELECTRONIC SIGNATURE

Your electronic signature is the legal equivalent of a manual signature on any applicable Client documents.  You expressly authorize us to use your e-signature to indicate your validation of care notes and daily timesheets, which may be used to verify services for third-party insurance companies, provincial regulations, or other governing bodies.

CERTIFICATION OF AUTHORITY

If someone other than Client (hereafter referred to as an “Authorized Agent”) signs this Agreement on behalf of Client, said Authorized Agent hereby certifies that he/she has the authority to enter into this Agreement on behalf of said Client and bind Client to the terms hereof. Client and Authorized Agent accept full responsibility for payment of all fees incurred for services rendered to Client pursuant to this Agreement.

TERMINATION

We reserve the right to terminate this Agreement and/or deny services for good cause, which includes failure to provide a safe environment to our employees, delinquencies in paying invoices, requests for services that we cannot legally provide and/or a breach of a material term of this Agreement. Upon notice of termination, you are obligated to pay all outstanding amounts owed under the Agreement.  

ENTIRE AGREEMENT; AMENDMENTS; NOTICE

This Agreement constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all other prior agreements and understandings between us.  This Agreement shall be governed and construed in accordance with the laws of the province of Ontario. We may amend this Agreement at any time by providing written notice to you, and such amendment shall take effect as of the effective date stated in any such notice, without requiring your signature. You agree to provide us with contact information for notices from us to you related to this Agreement and the Services, and you agree that if we contact you using the contact information you provide, that we have given you sufficient notice under this Agreement of any amendments or other changes, and that you cannot challenge the notice or any changes addressed by such notice (including without limitation updates to Billing Rates). 

You (Client), directly or as the Care Recipient's Authorized Agent, have read and fully understand the contents of this Agreement and agree to the terms. 

Appendix A

Scope of caregiving duties

Assist Care Recipient with activities of daily living, which includes bathing, dressing, toileting, grooming and transferring.

Prepare meals following Care Recipient’s prescribed dietary restrictions and the Balanced Care Method.

Light housekeeping duties – the Client will provide in writing a list of housekeeping activities to be performed and agreed upon by the Company.

Conduct basic errands, such as grocery shopping.

Incorporate aspects of the Balanced Care Method into the Care Recipient’s care (e.g., go for a walk, visit the local senior center, play a board game).

Provide or schedule transportation services e.g. Care Recipient’s appointments, errands etc.

Medication Reminders – Caregivers will provide medication that is already in blister packs and/or pill boxes. 

Caregivers will NOT dispense medication that is in prescription containers. 

Medication delivery through IV, injections and all other treatments that require the supervision of a regulated health care professional will NOT be performed.

Assistance with exercises – All exercises will be directed and performed based on the written recommendation of a regulated health care professional or the Client and/or Power of Attorney for Health.

Mobility and Transfer Assistance - Assist Care Recipient with transfers (caregivers can ONLY assist with transfers that the Care Recipient is able to perform as approved by the occupational therapist). For any transferring assistance, the Care Recipient must be able to bear weight. If the Care Recipient is unable to bear weight they must be assessed by an occupational therapist prior to transferring.

All modifications to Care Recipients care needs must be approved in writing by us. We will reassess as needed and make recommendations. If the Client and Company agree upon the recommendations, such modifications will be implemented within 2 business days.

CARE AGREEMENT

BILLING RATES	BILLING RATES	BILLING RATES

Standard Rate	Complex Care Rate

Hourly Care	$ [hrlyrate]/hour	+ $ [hrlypremium]/hour premium over Standard Rate

Live-In Care	$ [dailyrate]/day	+ $ _____/day premium over Standard Rate

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Name of Care Recipient / Authorized Agent

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Signature	___________________________________________
Date

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Name of Care Recipient / Authorized Agent

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Signature	___________________________________________
Date