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Home Health Care Quote Template

Care plan hours, tasks covered, shift minimums and the nursing boundary. Free PDF, no sign-up.

Home care is quoted from an assessment, which is what makes the hourly rate a commitment rather than a guess: somebody has been to the house, met the client, and written a care plan that says how many hours and what happens in them. The document that follows has an unusual duty — it is read by an adult child making a decision under stress. It should be exact about the tasks a caregiver may perform, and honest about the ones that need a nurse.

Issued by

Willow Bend Home Care

310 Cocoanut Avenue

34236 Sarasota, FL

United States

care@willowbendhome.example

Bill to

Family of Mr. Alastair Penhaligon

2145 Bayshore Road

34234 Sarasota, FL

United States

j.penhaligon@example.com

Quoted price

$1,710.00

Valid for 30 more days · Sep 5, 2026

Fixed price, valid until September 5, 2026.

Care plan

Two named caregivers cover the weekday rota so the household sees familiar faces, with a third as designated cover. Medication is prompted and recorded but never administered; that requires the visiting nurse arranged through your physician.

Description	Qty	Rate	Tax	Amount
Personal care — weekday shifts Four hours each weekday morning, 20 hours a week; bathing, dressing, breakfast, mobility	20	$32.00	—	$640.00
Weekend shifts Six hours Saturday and Sunday, 12 hours a week; same care plan plus outings	12	$35.50	—	$426.00
Overnight cover — awake Two nights weekly, 10pm to 6am, 16 hours a week; caregiver awake throughout	16	$29.00	—	$464.00
Care plan assessment and review Initial assessment plus a 30-day review with the family	1	$180.00	—	$180.00

Subtotal	$1,710.00
Total	$1,710.00

Terms

Valid 30 days. Billed fortnightly in arrears. Four-hour minimum per shift. Rates reviewed annually with 30 days' written notice.

Quote #QUO-2604 · Willow Bend Home Care · Page 1 of 1

What this quote commits you to

How long it stands: 30 days at the hourly rates for the care plan as assessed; a plan that changes before service starts is priced again.
What it does not cover: Skilled nursing tasks requiring an RN, medical supplies and equipment, transport in a caregiver's own vehicle, and live-in cover.
What would change the price: A change to the hours or to the level of assistance in the care plan, reviewed with the family before it takes effect.
How the client accepts it: Sign the service agreement and the care plan together; caregivers are matched to the household once both are back.

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What to put on a home health care quote

Hours per week and the shift pattern, with the minimum shift length stated
The care plan summarised: personal care, mobility, meals, medication reminders
The boundary — what needs a licensed nurse and is not included here
Caregiver continuity: how many caregivers, and who covers absence
Rates by shift type: weekday, weekend, overnight, live-in
Holiday rates, named by date
How the care plan is reviewed, and how a change to it changes the price

Questions

Why is there a minimum shift length?

Because a caregiver's travel and the agency's scheduling do not scale below it, and one-hour visits are how a rota becomes unstaffable. State the minimum on the quote; families accept it easily when it is explained as continuity rather than as a policy.

What is the difference between care and nursing on this document?

Medication reminders, bathing, dressing, meals and mobility are care. Wound care, injections and anything requiring clinical judgement are nursing, and a quote that blurs the line is promising a family something the caregiver is not permitted to do.

How should a rate increase be handled mid-engagement?

With notice written into the quote. Families budget carefully, and a change with thirty days' notice against a stated review point is very different from an increase that arrives on an invoice.

Is an elder care quote a different document?

No — this is one. The care plan, the shift minimum, the caregiver continuity and the line between care and nursing are what an elder care quote is made of, and the sample beside this text is exactly that: hours for an older person at home, priced from an assessment. Two things are worth adding when the need is memory care rather than physical assistance. Continuity stops being a preference and becomes part of the care, so name the caregivers and the cover rather than promising a rota; and say plainly whether overnight hours are awake or sleeping, because the two are different work at different rates and are the most common thing a family assumes the other way.

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