Client Agreement
This agreement (the “Agreement”) is a binding agreement between ____________________, the client
(“You”), and Chefs for Seniors, LLC (“Chefs for Seniors”) that states the terms and conditions under
which You may receive Chef for Seniors meal preparation and grocery shopping services.
This Agreement constitutes the entire agreement between the parties and supersedes all prior agreements,
representations, and understandings of the parties, written or oral.
1. Initial Assessment
Before Chefs for Seniors begins any grocery shopping or meal preparation of any kind, Chefs for Seniors,
through its designated representative and meal preparation personnel, (“the chef”), will conduct a food
preference and kitchen assessment of Your home. During this assessment, the chef will determine how
You like to eat, including any dietary preferences or requested restrictions. Based on this assessment,
Chefs for Seniors will prepare a shopping list and customized meal plan for the agreed upon time period.
2. Responsibilities
Once the menu for the agreed time period is accepted, Chefs for Seniors, in return for Your payment, will
prepare the meals that You ordered for the requested time period. On Your designated service day, the
chef will shop at Your grocery store of preference, bring the groceries to Your home, along with cooking
tools and equipment provided by Chefs for Seniors, and prepare the meals in Your kitchen. At the end of
the meal preparation session, the chef will store the food, label it, and leave complete handling
instructions for reheating or serving the meals.
3. Limits to Chefs for Seniors Service
Chefs for Seniors is not a home medical care provider. Chefs for Seniors’ chefs do not claim any
expertise beyond being trained as a chef. Chefs for Seniors will not provide any in-home medical care or
assistance of any kind. By entering into this agreement, You acknowledge that Chefs for Seniors has
advised You to seek the advice of Your physician or other health care provider if You have any medical
questions or questions regarding other things such as the menus provided, any medical conditions, postpregnancy and post-partum conditions, nutritional supplements or exercise regimes.
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4. Client Information
Name(s):
Address:
Phone Number:
Emergency Contact Name ________________________
Emergency Contact Phone Number ________________
First Service Day:
Special Instructions/Considerations:
5. Food Allergies
Client Food Allergies:
I hereby acknowledge that I have informed Chefs for Seniors of all possible food allergies and other
dietary restrictions necessary for the provision of Chefs for Seniors Services.
Client #1 Initials
Client #2 Initials
Chef Initials
6. Service Costs and Fees
The initial consultation between You and a Chefs for Seniors’ chef is offered free of charge. Chefs for
Seniors performs the grocery shopping for a surcharge of $15 plus the cost of groceries. The in-home
preparation of meals is charged at an hourly rate of $30. Any additional fees or changes in cost will be
discussed at the initial consultation or subsequent consultations.
7. Methods of Payment
You will be asked to pay in the form of cash or check on the service day unless otherwise agreed to.
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8. Disputes and Choice of Law
All questions concerning the construction, validity, and interpretation of this Agreement shall be
governed by and construed in accordance with the laws of the State of Wisconsin, without giving effect to
any choice of law or conflict of law provisions (Whether of the State of Wisconsin or any other
jurisdiction) that would cause the application of the laws of any jurisdiction other than the State of
Wisconsin. The Parties consent to the exclusive jurisdiction and the venue of the Circuit Court of Dane
County, Wisconsin.
By signing below, You agree that You have read and understand the above terms and conditions and
agree to abide by them for the time period agreed upon for service.
Signature (Client)
Printed Name
Date
Signature (Chefs for Seniors,
Printed Name
Date
LLC)
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WAIVER AND RELEASE OF LIABILITY
WHEREAS I,
, wish to receive food preparation and grocery
shopping assistance from Chefs for Seniors, LLC at My home, located at
(hereinafter referred to as “My Home”) while receiving services from Chefs for Seniors, LLC (“LLC”);
AGREEMENT:
In entering this agreement with the LLC and the chef, I acknowledge the limited role of Chefs for Seniors
in providing grocery shopping and personal chef services. I acknowledge that Chefs for Seniors is not a
home medical care provider and does not provide any services associated with such providers.
I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS
CONTENTS. I FURTHER UNDERSTAND THAT I HAVE HAD AN OPPORTUNITY TO
SEEK LEGAL COUNSEL AND NEGOTIATE THE TERMS OF THIS AGREEMENT. I
AM AWARE THAT THIS IS A CONTRACT BETWEEN MYSELF, THE CHEF, AND
CHEFS FOR SENIORS, LLC, AND I SIGN IT OF MY OWN FREE WILL.
Signature
Date
Printed Name
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