In-home care agreements with the weekly charges in plain view
Every service per week or fortnight beside the once-off fees, a visit schedule the family can read, your terms and an expiry date.
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In-home care and support providers use QuoteCloud to send care agreements as one document: services as repeating charges per week or fortnight, once-off assessments, the visit schedule, terms with a start and expiry date and your consent wording. The client and their representative sign online and the first week can be paid on signing.
A sample in-home care agreement from a fictional provider, Kinfield Health, for Rosalind Avery. Her week is pinned to the fridge door as a paper calendar: personal care on Monday, Wednesday and Friday at 8 am, physiotherapy on Tuesday at 10:30 am, a nurse visit on Thursday at 9 am and lunch prepared every weekday at noon. Beside it, the signed agreement: $676 a week and an estimated $4,296 over six weeks, signed by Rosalind and her daughter Claire, with $916.00 paid on signing.
The care agreement, page by page
Rosalind's six weeks of recovery care at home, as Claire read it. One document from the provider's care agreement template, with the intake, fees, week, terms and consent together.
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Kinfield HealthIn-home care agreement KH-2611 Sample · fictional provider
In-home care agreement
Rosalind's recovery care at home
Your care plan after your hospital stay, set out visit by visit: personal care, a weekly physiotherapy visit and the fees, so you and Claire know what to expect before the first visit.
About you
FormForms block · completed before the plan was written
Preferred visit times Mornings, from 8:00 amGetting around at home Walks with a frame indoorsHome access Key safe by the side doorWho else should we talk to? Claire Avery (daughter), 555 0100Anything we should know before the first visit? Mum has a small dog, Biscuit, who is friendly.Completed by Claire Avery · Tue 27 Oct, 6:10 pm
Cover & intake
Her name, and her family's answers
The cover with the expiry date, then the intake questions Claire answered in a Forms block before the plan was written (Business plan).
Intake & referral forms -
Kinfield HealthIn-home care agreement KH-2611 Sample · fictional provider
Your care plan and estimated fees
6 weeks from Mon 2 Nov 2026
Item Qty Rate Amount Once-off Initial home assessmentOccupational therapist, home safety and equipment1 visit $240 $240.00 Each week Repeating Personal care visit · 1.5 hShowering, dressing and a meal set-up3 visits $102 $306.00/wk Physiotherapy home visitWith Marcus Tan, falls-prevention exercises1 visit $135 $135.00/wk Nurse visit · wound careRegistered nurse1 visit $145 $145.00/wk 5 meals $18 $90.00/wk 1 trip $55 $55.00/wk - Once-off
- $240.00
- Each week
- $676.00/wk
- Over 6 weeks (estimate)
- $4,056.00
- Estimated total
- $4,296.00
- Paid on signing · assessment and first week
- $916.00
Provider's wordingThese are estimated fees. Any insurance or other funding benefit you may be entitled to is not calculated here: please check with your insurer or funder.
Weeks 2 to 6 are invoiced each week by Kinfield Health.
Fees
Once-off and weekly, side by side
The home assessment once, then every service per week as a repeating charge. Claire ticked weekday lunches; the weekly amount, the estimate over six weeks and the payment on signing follow.
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Kinfield HealthIn-home care agreement KH-2611 Sample · fictional provider
Your week
6 weeks · Mon 2 Nov to Sun 13 Dec 2026
Service Mon Tue Wed Thu Fri Sat Sun Personal care8:00 am Yes Yes Yes Physiotherapy10:30 am Yes Nurse visit9:00 am Yes Lunch prepared12:00 pm Yes Yes Yes Yes Yes - Week 1
- Week 2
- Week 3
- Week 4
- Week 5
- Week 6
Visit times are confirmed by your care coordinator, Leah Whitford.
Agreement terms
StartsMon 2 Nov 2026ExpiresSun 13 Dec 2026- Changes to your planIf your needs change, we send a revised agreement for you to read and sign before the change starts.
- Cancelling a visitPlease give us 24 hours' notice. Visits cancelled with less notice are charged at the visit rate.
- InvoicesYour first week is paid when you sign. Each later week is invoiced by Kinfield Health.
- Your informationHow we collect, use and store your information is set out in our privacy policy, which we gave you at intake.
- Ending the agreementEither of us can end this agreement with 7 days' notice. It ends on its expiry date unless we agree a new one.
Week & terms
Her week, then the terms
Each visit on its day and time, then the start and expiry dates, cancellations, invoices and how changes are agreed. Nothing renews by itself.
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Kinfield HealthIn-home care agreement KH-2611 Sample · fictional provider
Consent and acknowledgement
Locked wording · your team can't edit it
Please read and confirm before signing. Rosalind signs as the client; Claire signs as her representative.
- I have read this plan and cost estimate, and my questions have been answered.
- I understand these are estimated fees. A change to the plan is sent to me as a revised agreement to sign.
- I agree that Kinfield Health may share this plan with my referring practitioner.
- I understand I can ask to change or end the plan at any time.
2 of 2 signed
- Rosalind AveryClient SignedWed 28 Oct, 10:12 am
- Claire AveryDaughter and representative SignedWed 28 Oct, 10:15 am
Paid on signing$916.00Paid via Stripe
Certificate of authenticity and audit trail attached
Consent
Two signers, first week paid
Rosalind and Claire each confirm the locked wording and sign in their own browser; the assessment and first week are paid through Stripe.
Consent, acknowledgements & multiple signers
Before the agreement ends
A six-week agreement has an end date. This is how a care coordinator might plan what comes next: your own process, drawn as an example. QuoteCloud renews nothing by itself.
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Week 1
Signed and started
Rosalind and Claire signed, and the assessment and first week were paid on signing.
eSignature + payment -
Week 4
Check the plan still fits
The coordinator asks the family how the visits are going, in a comment or a call.
Comments -
14 days
Expiring Soon
The agreement appears in the Expiring Soon filter two weeks before its end date.
Expiring Soon Essentials and up -
7 days
Send the next agreement
If care continues, send a new agreement from the template, or a revised version if the plan changes.
Revise Last Version -
End date
The agreement ends
It ends on its expiry date unless the family has signed a new one.
Expiry date
Expiry dates and the Expiring Soon filter are on Essentials and up. Follow-up with the family is your coordinator's own process.
Charges shown per week or per fortnight
The same agreement, with its repeating charges shown in the period the family budgets in. Tick transport or untick lunches and every total follows.
Your care plan and estimated fees
6 weeks from Mon 2 Nov 2026
| Item | Qty | Rate | Amount |
|---|---|---|---|
| Once-off | |||
Initial home assessmentOccupational therapist, home safety and equipment
|
1 visit | $240 | $240.00 |
| Each week Repeating | |||
Personal care visit · 1.5 hShowering, dressing and a meal set-up
|
3 visits | $102 | $306.00/wk |
Physiotherapy home visitWith Marcus Tan, falls-prevention exercises
|
1 visit | $135 | $135.00/wk |
Nurse visit · wound careRegistered nurse
|
1 visit | $145 | $145.00/wk |
| 5 meals | $18 | $90.00/wk | |
| 1 trip | $55 | $55.00/wk | |
- Once-off
- $240.00
- Each week
- $676.00/wk
- Over 6 weeks (estimate)
- $4,056.00
- Estimated total
- $4,296.00
- Paid on signing · assessment and first week
- $916.00
Provider's wordingThese are estimated fees. Any insurance or other funding benefit you may be entitled to is not calculated here: please check with your insurer or funder.
Weeks 2 to 6 are invoiced each week by Kinfield Health.
Each service per week
Personal care three times a week, a physio home visit, a nurse visit and weekday lunches come to $676 a week. The assessment and first week, $916.00, are paid on signing.
- Repeating charges with a weekly period label
- Optional services the family ticks
- Later weeks invoiced by the provider
Your care plan and estimated fees
6 weeks (3 fortnights) from Mon 2 Nov 2026
| Item | Qty | Rate | Amount |
|---|---|---|---|
| Once-off | |||
Initial home assessmentOccupational therapist, home safety and equipment
|
1 visit | $240 | $240.00 |
| Each fortnight Repeating | |||
Personal care visit · 1.5 hShowering, dressing and a meal set-up
|
6 visits | $102 | $612.00/fortnight |
Physiotherapy home visitWith Marcus Tan, falls-prevention exercises
|
2 visit | $135 | $270.00/fortnight |
Nurse visit · wound careRegistered nurse
|
2 visit | $145 | $290.00/fortnight |
| 10 meals | $18 | $180.00/fortnight | |
| 2 trip | $55 | $110.00/fortnight | |
- Once-off
- $240.00
- Each fortnight
- $1,352.00/fortnight
- Over 3 fortnights (estimate)
- $4,056.00
- Estimated total
- $4,296.00
- Paid on signing · assessment and first fortnight
- $1,592.00
Provider's wordingThese are estimated fees. Any insurance or other funding benefit you may be entitled to is not calculated here: please check with your insurer or funder.
Fortnights 2 and 3 are invoiced by Kinfield Health.
The same agreement, per fortnight
Quantities per fortnight, $1,352 a fortnight with lunches. The payment on signing becomes the assessment and first fortnight, $1,592.00. The estimated total stays $4,296.
- The period label your clients budget in
- Same services, same estimated total
- Set per template or per document
Make your care agreement template in the trial
Free for 14 days, no credit card required. Send us the care agreement you use now and we'll convert one template for you during the trial.
Sample agreement · KH-2611
What the family budgets for, in plain view
Six weeks of care at home come to $676 a week and an estimated $4,296 in all. Claire saw the weekly figure change when she added lunches, before anyone signed.
Care changes. The agreement keeps up.
Claire asked for a later physio visit in a comment, and the coordinator replied in the same thread. When a change affects the visits or the fees, send a revised version with Revise Last Version, and the family signs again before the change starts.
On the Business plan, version history keeps every version, so you can see what was agreed and when.
- Comments and replies inside the agreement
- Revise Last Version for a changed plan
- An expiry date on every agreement
- Signed agreements can update your client record through Zapier
Version history: Business plan
Practice management & accounting integrationsNotes from your care coordinator
- Leah Whitford is your care coordinator and first point of contact.
- Your first visit is the home assessment on Mon 2 Nov at 9:00 am.
- Please keep the walking frame by the bed for the first two weeks.
Claire AveryCould the Tuesday physio visit be after 10 am? Mum has a standing appointment first thing.
Leah, Kinfield HealthYes, Marcus will come at 10:30 on Tuesdays. I've updated your week.
Activity
- Intake form completedClaire Avery, in the document
- Agreement openedClaire Avery, from the email link
- Meal preparation added+$90.00 a week
- Signed by Rosalind and ClaireCertificate of authenticity attached
- First week paid$916.00 via Stripe
- Client record updatedIn the practice system, through Zapier
What a care agreement template carries
Build it once per service type. Coordinators change quantities and options instead of rewriting the agreement.
Services per week or fortnight
Each service as a repeating charge with a period label, beside the once-off fees, with the estimate over the agreement.
A visit schedule
Each visit on its day and time, the provider's own plan. QuoteCloud doesn't roster staff or book visits.
Intake inside the agreement
Questions the client or family answer in a Forms block, in the same document (Business plan).
Consent wording, locked
Your terms and consent wording in blocks your team can't edit (Business plan).
The client and their family
Several signers, each in their own browser, with no account needed to sign.
First week on signing
Once-off fees and the first period paid on signing. Later weeks are your invoices; QuoteCloud doesn't bill them.
Send a care agreement in five steps
From the referral to the first visit, as a coordinator works it.
Intake first
Send the intake form as a document, or let your website or referral system create it through the API or Zapier.
Start from the template
Open the care agreement template for that service, with your terms and consent wording in place.
Set the week
Set the visits per week on each repeating charge, the once-off fees and the start and expiry dates.
Everyone signs
The client and their representative read it, tick any extras, confirm the acknowledgements and sign.
First week paid
The once-off fees and first week are paid on signing. Later weeks are invoiced from your own systems.
Care agreement questions, answered
Can a care agreement show charges per week or per fortnight?
Yes. Price tables support repeating price items with a period label beside once-off fees, so each service shows its charge per week or per fortnight, with the estimate over the agreement. Use the period your clients budget in. Price tables are on the Essentials plan and above.
Does QuoteCloud bill the weekly care charges?
No. The weekly or fortnightly charges are shown in the agreement, and you can take the once-off fees and the first period as a payment on signing. Later periods are invoiced from your own practice or accounting system. QuoteCloud does not set up recurring billing, instalments or payment reminders.
Can the client and a family member or representative both sign?
Yes. A document can have several signers, each with their own signature block, and nobody needs an account to sign. Each signs in their own browser, or in person on your device, and you can add an optional one-time passcode sent by email before signing.
What happens when the care plan changes?
Send a revised agreement with Revise Last Version: the family reads the change and signs again before it starts. On the Business plan, version history keeps every version. Comments let the family ask for small changes inside the document first.
Do care agreements renew automatically?
No. Each agreement has an expiry date, and the Expiring Soon filter shows the agreements ending in the next few days. If care continues, your coordinator sends a new or revised agreement for the family to sign.
Can QuoteCloud roster care workers or schedule visits?
No. The visit schedule in the agreement is your own plan, shown as a table block so the family can read it. Rostering and bookings stay in your care management system, which can be connected through Zapier, Make or the API where it has a connector.
More for health providers
Every page of the QuoteCloud healthcare microsite.
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Funded-plan service agreementsSupports, rates and a schedule set out for a participant and their nominee, with the agreement signed by both.Explore
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Consent, acknowledgements & multiple signersConsent wording in a locked block, acknowledgements ticked and every signer (patient, guardian or representative) signing online.Explore
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Intake & referral forms inside the documentThe Forms block collects intake details in the same document the client signs, and can start your next step through Zapier.Explore
- Treatment plans & cost estimatesThe plan, every fee line, what the estimate does not include and an expiry date, accepted and signed before treatment starts.
- Physio, OT & psychology programsSessions per week, the program schedule and a choice of program options, with the first fees paid on signing.
- Cosmetic & elective treatment quotesTreatment options side by side, a deposit to book, an expiry date and the patient's acknowledgements in one quote.
- Medical equipment & mobility quotesHire by the week or buy outright, delivery and set-up, product brochures as PDF pages, signed and paid online.
- Privacy, access & security for health providersWhat QuoteCloud confirms about hosting, encryption, signer verification and access control, and the questions to ask before you start.
- Practice management & accounting integrationsSigned agreements to your practice system through Zapier or the API, and accounting native on Business.
- Healthcare templatesReal QuoteCloud templates for treatment plans, home care contracts, medical services and pharmacy agreements.
- QuoteCloud implementation for health providersFee schedules loaded, estimate and agreement templates converted, consent wording locked and the team trained.
- FAQAnswers to the questions clinics, allied health, care providers and equipment suppliers ask most.
Your next care agreement, signed and started
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