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Professional Admission Agreement template for Adult Family Homes. Includes editable Word (.docx) and printable PDF formats.
[YOUR ADULT FAMILY HOME NAME HERE]
TEMPLATE • Inspection-Ready AFH Standard
This agreement is entered into on this _____ day of ____________, 20___, between [ADULT FAMILY HOME NAME] (Provider) and [RESIDENT / POA NAME].
Base Rate & Payment Schedule: Resident agrees to pay Provider a monthly base fee of $______ payable in advance on the first (1st) day of each calendar month.
Provider Signature / Date
Resident / POA Signature / Date
Get immediate access to the complete, unblurred Microsoft Word (.docx) and PDF files.
Names, legal representatives, and home identification details.
Detailed breakdown of room, board, and personal care services included in base rate.
Payment due dates, late payment terms, security deposits, and specialized care charges.
Daily schedules, visitor policies, smoking, personal items, and resident rights guarantees.
30-day notice provisions, emergency discharge criteria, and refund terms.
Legal binding signature block for resident, power of attorney, and AFH provider.
Or get this form included in the AFH Starter Kit ($129)