Healthcare Meal Service Agreement

HEALTHCARE MEAL SERVICE AGREEMENT

This Healthcare Meal Service Agreement ("Agreement") is entered into between Service Provider Name: and Client Name: . The Effective Date of this Agreement is .

1. Client Information

2. Provider Information

3. Services to Be Provided

Provider will prepare and deliver meals to Client in accordance with the dietary instructions and service frequency selected below. Meal components, portion size, and preparation will be consistent with documented medical or dietary requirements and Provider's standard safe food handling practices.

4. Medical & Dietary Information

I understand that Provider is not a medical provider and will follow written dietary orders provided by Client's treating physician or registered dietitian. Provider must be notified in writing of any dietary orders or changes. Authorization for Provider to follow clinical diet orders: Physician or Dietitian Name:

5. Fees, Billing, and Payment

Client agrees to pay Provider the fees described below. Fees are subject to change with thirty (30) days' written notice to Client.

Cancellations must be received at least days prior to scheduled delivery to avoid full charge. Missed deliveries due to Client absence or late cancellation are billed in full.

6. Responsibilities

Provider Responsibilities: prepare meals consistent with documented orders, deliver on scheduled days, follow safe food handling and temperature controls, label meals with service date and reheating instructions, and notify Client of ingredient substitutions that affect dietary orders.

Client Responsibilities: provide accurate medical and dietary information, secure refrigeration or warming equipment as required, ensure safe access for delivery, and timely payment of fees. Client must notify Provider in writing of any change in medical condition or physician/dietitian orders.

7. Liability, Indemnification, and Disclaimer

Provider does not practice medicine and meals are intended to support nutritional needs in accordance with documented orders. Client acknowledges residual risk of allergic reaction, aspiration, or other adverse events associated with food consumption. To the fullest extent permitted by law, Client releases Provider from liability for adverse health outcomes related to adherence to Client-provided or clinician-prescribed dietary orders, unless such harm is solely caused by Provider's gross negligence or willful misconduct.

Client agrees to indemnify and hold Provider harmless from claims arising out of Client's failure to disclose allergies, medical conditions, or other pertinent dietary information.

8. Emergency Protocols

In the event of suspected food-related allergic reaction or other medical emergency observed at delivery or reported by Client, Provider is authorized to contact emergency medical services and Client's emergency contact. Provider will document the event and notify Client's physician when contact information is provided. Client consents to emergency actions as necessary to preserve life and safety.

9. Confidentiality and Use of Health Information

Provider will treat Client information, including health and dietary information, as confidential and will use or disclose such information only as necessary to provide meal services, communicate with treating clinicians, or as required by law. Client authorizes Provider to receive and use clinical dietary orders from Client's treating clinicians.

10. Term, Termination, and Modification

This Agreement shall remain in effect until terminated by either party upon days' written notice. Provider may immediately suspend or terminate service when Client's condition or safety creates a substantial risk to Client or Provider staff.

Any modification to clinical diet orders must be provided in writing by the treating clinician or by documented written consent of Client.

11. Authorization and Expiration

By signing below, Client authorizes Provider to provide meal services as described in this Agreement and to follow documented dietary orders from Client's treating clinician. This authorization expires on unless earlier revoked in writing by Client.

12. Miscellaneous

This Agreement constitutes the entire understanding between the parties regarding meal services and supersedes prior oral or written agreements. If any provision is held invalid, the remaining provisions remain in full force. This Agreement may be executed in counterparts.

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