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Agreements with domestic staff

Agreements with domestic staff 2025

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The document is a Domestic Violence (DV) Screening/Documentation Form used by healthcare providers to assess and document instances of domestic violence in patients. It includes sections for patient identification, screening for signs of domestic violence, examination findings, safety assessment questions, referrals for legal or shelter assistance, reporting obligations, and consent for photographs. The form aims to ensure patient safety and facilitate appropriate interventions.

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Click ‘Get Form’ to open the agreement in the editor.
Begin by entering the date and patient ID at the top of the form. This helps in tracking and referencing the document accurately.
Fill in the patient’s name and provider’s name in the designated fields to ensure proper identification.
Indicate whether the patient is pregnant by selecting 'Yes' or 'No'. This information is crucial for appropriate care.
In the DV Screen section, mark if there is a positive screening or if there are suspicions of domestic violence.
Document examination findings in the provided space, ensuring all relevant details are captured for future reference.
Assess patient safety by answering yes or no to each question regarding potential risks and concerns related to domestic violence.
Complete referral sections as necessary, detailing any legal, shelter, or other referrals made for support.
Finally, address reporting requirements by indicating if any reports have been made to law enforcement or protective services.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Do I need a contract for my domestic worker?

This is a written contract between an Employer and Domestic Worker, setting out the rights and obligations of both. Employment will start on the of and will continue until ended. Either the Employer or Employee may terminate this agreement by providing at least 4 (four) weeks written notice.

Who is not covered by the FLSA?

Executive, administrative, professional and outside sales employees: (as defined in Department of Labor regulations) and who are paid on a salary basis are exempt from both the minimum wage and overtime provisions of the FLSA.

What is an example of a domestic staff?

Some common examples of household employees can include the following: babysitters, caretakers, cleaning people, domestic workers, drivers, health aides, housekeepers, maids, nannies, private nurses, and sometimes, gardeners or yard workers.

Does FLSA apply to domestic workers?

Persons employed in domestic service in private homes are covered by the FLSA; they must be paid at least the federal minimum wage for all hours worked and overtime pay at time and a half the regular rate of pay for all hours worked over 40 in a workweek, unless they are subject to an exemption.

What employees are excluded from FLSA?

Employees exempt from the FLSA typically must be paid a salary above a certain level and work in an administrative, professional, executive, computer or outside sales role. The Department of Labor (DOL) has a duties test that can help employers determine who meets this exemption criteria.

How do you manage domestic staff?

Develop a schedule: Develop a schedule that outlines when staff members are expected to work, and what their specific duties are during that time. This can help ensure that all tasks are covered and that there is no confusion about who should be doing what. Make sure to include any days off or bank holidays.

Are domestic workers covered by FLSA?

Domestic workers such as nannies, housekeepers, companions, babysitters, cooks, waiters, maids, nurses, janitors, caretakers, handymen, gardeners, home health aides, personal care aides, and family chauffeurs are generally covered by the minimum wage and overtime requirements of the FLSA, with limited exceptions.

Agreements with domestic staff 2025

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