EXHIBIT 99.1
CLIENT AGREEMENT
THIS AGREEMENT, entered into the ____ day of ____________, 2003 by and
between ELDERWATCH, INC. and __________________________________________
(Client) each located at the address below.
Whereas Elderwatch, Inc. will herein provide a service to the Client
wherein it will visit on a regular and consistent basis a designated
individual who is a family member or friend who is confined to a medical
facility, retirement facility, private residence or nursing facility and
for which the Client desires regular reports as to the health, physical
treatment and well being of said family member or friend.
The parties agree as follows:
a) Elderwatch, Inc. shall provide a service to the Client by regular
visits to a specified individual and report back to the client.
b) The service shall be provided to the Client for a six (6) month
consecutive period for which the Client for which the client agrees to
pay in advance in monthly installments, the first installment being
payable upon execution of this Agreement. A security deposit equal to
one month's fees is also payable upon execution of this Agreement to be
held by Elderwatch, Inc. in a separate, interest-bearing account
established for such security deposits. This deposit shall be used to
offset unpaid services under the terms of this Agreement and shall be
promptly returned upon proper notice of termination.
c) This Agreement will be automatically renewed unless the Client
gives notification of termination in writing not less than thirty (30)
days prior to the expiration of any period. The Client understands that
to provide the service at the indicated cost, the service must be
provided on a regular, consecutive basis for a fixed period of time. In
case of the death of the individual visited, charges will be levied only
to the end of the month and any excess payments including deposits shall
be promptly returned.
d) The Client acknowledges that Elderwatch, Inc. and its
representatives or not medical personnel nor are their observational
services to be construed or interpreted as provision of medical services
or diagnosis. All services consist of a general observation of the
subject's condition and the condition of the subject's surroundings for
the Client's information.
e) This Agreement contains the entire understanding between the
parties and no oral representations or promises not contained herein
shall be construed as part of the agreement between the parties. Any
modification or alteration of this Agreement shall be reduced to
writing.
f) Any term of reference to "he" or "she" shall be gender-neutral and
shall apply to the appropriate individual as the case may be.
g) The parties designate Broward County, Florida as the situs for this
Agreement for purposes of notice and jurisdiction.
Elderwatch, Inc. Client
0000 Xxxxx Xxxx Xxxxxx Xxxx
Xxxxxxxx 00, Xxxxx 000
_____________________________________
Xxxxxxx, Xxxxxxx 00000 (print name)
_____________________________________
(address)
By: _____________________________________
_________________________________________
