Home Hospice Agreement

  • The Terms of Use stated herein (collectively, the “Terms of Use” or this “Agreement”) constitute a legal agreement between you and Hospice Bangladesh (HBD). In order to use the Service defined below you must agree to the Terms of Use that are set out below:
  • The Company reserves the right to modify, vary and change the Terms of Use or its policies relating to the Service at any time as it deems fit. Such modifications, variations and or changes to the Terms of Use or its policies relating to the Service shall be effective upon the posting of an updated version at Hospice Bangladesh website. You agree that it shall be your responsibility to review the Terms of Use regularly whereupon the continued use of the Service after any such changes, whether or not reviewed by you, shall constitute your consent and acceptance to such changes.
  • Home care is the main focus of the HBD. Services are provided in the patient’s place of residence by a team of hospice staff. Consultation (visit/over phone) and visits for urgent matters and pain and symptom control are available 24 hours a day, 7 days a week. As the diseases condition is not static and fluctuate, so HBD will be not responsible for the diseases condition.
  • Patient’s Primary Physician will collaborate with the Hospice team and also consult with the Hospice Consultant, as necessary, for management of the symptoms associated with patient illness.
  • I agree that HBD will consult with me and provide advice through phone call and sms.
  • The service cost for Hospice’s care has been explained to me. I have read the explanation regarding the benefits, provisions and scope of services to be offered to me.
  • I assure you that staff of HBD will always remain secured at my home during duty time and HBD is ensuring me that the security of my home will not be hampered by their staff.
  • Nurse(HBD) will only do patient oriented service asked/ordered by HBD admin.
  • HBD is committed to serving you (Patient and family) with both courtesy and respect and ask them (Patient and family) to treat staffs of HBD in the same manner. HBD shall be constrained not to serve those who use offensive language or behave in an aggressive manner.
  • In case of Tele-Hospice, Hospice e-store and Monthly package, payment must be paid full in advance. No payment is refundable.
  • Privacy and confidentiality will be maintained by both parties (HBD and patient family).
  • Both parties can stop service with 24hour prior notice.

We have read, understand and agree with the above information and Hospice Bangladesh preserve the right to take any action at any time if any of point in this agreement become violated. I hereby declare that all the information provided in this form is true and correct to the best of my knowledge. In case any of the information provided is found to be false or untrue or misleading or misrepresenting. . I am aware that I may be held liable for it.

I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.

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