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: _____________________________________
____________________________________
