Step 6 of 7 · Contract / Offer Letter

Review & Sign Your Saintly Agreement

Select the agreement that matches your role (independent contractor or employee), review the terms carefully, complete the required fields, and sign electronically. This step finalizes your working relationship with Saintly Home Health LLC.

Onboarding Progress Step 6 of 7

1. Interview Review
2. AZ New Hire Form
3. Offer Packet
4. Orientation Checklist
5. Skills Competency
6. Contract / Offer Letter
7. Completion Log

Instructions:

• Choose your agreement type below (RN, PT, OT, ST/SLP, MSW, or Employee).
• Read the summary and enter your information and rate schedule as agreed.
• Check the acknowledgment box and type your full legal name as the signature.
• Submit the form to send it securely to the Saintly HR inbox.

Once your contract is submitted, continue to Step 7 – Onboarding Completion Log.

Step 6 · Contracts

Onboarding Agreements

Please select the appropriate agreement type and review it carefully. After reading in full, complete the fields, sign electronically, and submit.

Agreement for Nursing Services (Independent Contractor)

This agreement is between Saintly Home Health LLC (“AGENCY”) and the undersigned nurse (“BUSINESS ASSOCIATE” or “NURSE”), acting as an independent contractor.

AGENCY: Saintly Home Health LLC, 64 East Broadway Rd, Suite 200-235, Tempe, AZ 85282

CONTACT: saintlyhomehealth@gmail.com · (480) 360-0008

Purpose

To provide Skilled Nursing Services to AGENCY patients as an independent contractor nurse in accordance with federal and state regulations and Agency policies.

Key Terms

• AGENCY admits patients and coordinates care. NURSE does not admit patients.
• NURSE performs assessments, treatments, documentation, and reports changes in condition.
• NURSE participates in case conferences, discharge planning, and performance improvement.
• NURSE must maintain licensure, competencies, and infection control requirements.
• NURSE is an independent contractor and responsible for all taxes.

Compensation & Term

AGENCY compensates NURSE per Appendix A rate schedule, with invoices paid within 15 days, and the Agreement renews annually unless terminated with 30 days’ notice.

HIPAA & Confidentiality

NURSE agrees to safeguard PHI, comply with HIPAA, report breaches promptly, and return/destroy PHI when the Agreement ends unless law requires retention.

Nurse Information

Nurse Name (as it will appear on the contract) *

Credential (RN / LPN / LVN) *

Address *

Phone *

Effective Date of Agreement *

License Number

Appendix A – Rate Schedule

Enter the agreed-upon compensation rates. Leave blank any that do not apply.

Start of Care (SOC)

Resumption of Care (ROC)

Recertification Visit

Skilled Nursing Visit (SNV)

PRN Visit

After-Hours / Weekend Visit

Travel Rate (if applicable)

Acknowledgment & Signature

I confirm that I have read and understand the Agreement for Nursing Services in full, and I agree to the terms and conditions as stated above.

Nurse Signature (type full legal name) *

Date *

Once submitted, a copy will be sent to Saintly Home Health LLC for review and countersignature, if required.

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Next Step: Completion Log →