TERMINATION AGREEMENT

Purpose

To establish a process of termination of services

GENERAL PRINCIPLE: SPHC sub – contractor / staff must: 

    • Be courteous, truthful, and respectful when dealing with clients.
    • Carry out their professional work in a competent and objective manner.
    • Be in continuous compliance with SPHC policy and procedures.
    • Comply at all times with all federal, state and local laws and regulations, including but not limited to laws relating to license, scope of practice.

2.   Termination:

Either Client or SPHC may terminate this Agreement at any time by providing 14 days written notice.

If either party terminates the Agreement, all unpaid services and expenses become due at the time of services. When adequate notice is given by the client there will be no charges due to the notice given in a timely matter.

SPHC first applies Client deposits to outstanding balances and then pays any remaining funds to Client.

3.   Contact Information:

At any time, Client is encouraged to Director of Operation at 1127 Brown Ave; Columbus, Ga, 31906 or call 706 221 3170 to ask questions or discuss any issues whatsoever.

4.   Complaint and Resolution Process:

Client acknowledge that SPHC caregivers are professionals trained to respect individuals and properly perform duties as assigned. However, Client may at any time submit a complaint to SPHC concerning any potential or real abuse, neglect or exploitation.

Client may directly contact the Director of Operation as listed above. Otherwise Client, may contact Adult Protective Services (APS) at 1 888 774 0152. Complaints can be reported to the Director of Operation at SPHC listed in paragraph 17. Or you may contact 2 Peachtree St NA, Atlanta, Ga 30303 or call 404 657 5726; 1 800 878 6442 at the Health Facility.

5.   Client’s vehicle / Personal funds:

SPHC does NOT allow caregivers or any staff members to handle. The client’s personal vehicle or personal funds at any time; for any reason.

Caregiver will under no circumstances assist Client to write checks, use bank card, or credit cards. Client by signing this Agreement you agree that you will not ask staff / clients to handle your personal funds or personal vehicle. Initialing the Agreement here: (______)

Client’s signature below indicates that Client or the Client Representative has read, understands and is in agreement with the terms and conditions of this Agreement.

____________________________________        _____________________

Client / Representative Signature                                                                      Date

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