Adult Day Care Service Agreement Form Template

Finding quality care for your loved ones is one of the most important decisions families make. An adult day care service agreement helps establish clear expectations between care providers and families, ensuring transparency around schedules, services, fees, and emergency protocols.

This adult day care service agreement template from Paperform makes it simple to onboard new clients professionally while capturing all the essential information you need—from attendance schedules and transportation requirements to medication administration and dietary preferences. Whether you run a senior day program, specialized memory care facility, or community-based adult day services, this template helps you document the complete care arrangement in one organized form.

Why adult day care centers choose Paperform

Adult day care providers serving seniors and their families need forms that are both professional and easy to use—especially when family members may be completing forms on behalf of participants. This template is designed with clarity and accessibility in mind, walking families through service details, care preferences, and legal agreements in a logical flow.

Paperform's calculation engine makes it easy to display daily rates, weekly fees, and add-on charges (like transportation or specialized activities) with totals that update automatically as families select their preferred services. You can even integrate Stripe or PayPal to collect deposits, enrollment fees, or set up recurring payments for ongoing care.

Once a family submits the agreement, you can use Papersign to generate a legally binding signature document, capturing consent for medication administration, transportation authorization, and photo releases in one clean audit trail. No more chasing down wet signatures or managing multiple PDFs.

For day-to-day operations, connect your form to Stepper to automate your intake workflow—create a participant record in your care management system, notify relevant staff about dietary restrictions or medication schedules, add emergency contacts to your database, and send welcome packets automatically. This keeps your team focused on care, not paperwork.

Built for senior care providers who value trust and clarity

This template serves adult day care centers, senior day programs, memory care facilities, respite care providers, and social day programs looking to streamline their enrollment process while maintaining the personal touch families expect. With SOC 2 Type II compliance and secure data handling, Paperform gives you a professional platform families can trust with sensitive health and contact information.

Start with this template and customize it to match your program's specific services, pricing structure, and care protocols—all without writing a single line of code.