Healthcare Staffing Agency Contract Template

This Healthcare Staffing Agency Contract is made on [Date] by and between:

Client Facility: [Full Name / Company Name]
Address: [Address]

Staffing Agency: [Full Name / Company Name]
Address: [Address]

1. Services

The Client engages the Staffing Agency to provide healthcare staffing services under this Contract.

The Staffing Agency may provide the following personnel, as requested and accepted by the parties:

[registered nurses]
[licensed practical or vocational nurses]
[certified nursing assistants]
[allied health professionals]
[physicians or advanced practice providers]
[medical administrative staff]
[other healthcare personnel]

The Staffing Agency will provide only the staffing services described in this Contract unless the parties agree otherwise in writing.

2. Facility and Service Location

The staffing services will be provided at the following location or locations:

[Facility Name / Address / Department / Unit / Other]

Additional service locations, if any:

[Insert details]

3. Requests for Personnel

The Client may request personnel by providing the following information, as applicable:

[position or role]
[department or unit]
[shift date and time]
[specialty or skill requirements]
[minimum qualifications]
[anticipated duration of assignment]
[other request details]

Requests shall be submitted by:

☐ email
☐ phone
☐ scheduling portal
☐ other: [Describe]

4. Staffing Agency Responsibilities

The Staffing Agency agrees to:

use reasonable efforts to identify and assign qualified personnel;
verify licenses, certifications, registrations, and other required credentials before assignment, to the extent applicable;
confirm that assigned personnel meet agreed qualifications for the role;
provide scheduling and assignment coordination as reasonably needed;
notify the Client of assignment changes, cancellations, or availability issues as soon as reasonably possible.

Additional agency responsibilities, if any:

[Insert details]

5. Client Responsibilities

The Client agrees to:

provide accurate shift, role, and facility information;
orient assigned personnel to facility procedures, workflow, and site-specific expectations as reasonably needed;
supervise patient care activities performed at the facility;
maintain a safe work environment consistent with applicable requirements;
timely approve time records or otherwise verify hours worked;
pay all agreed fees and charges when due.

Additional client responsibilities, if any:

[Insert details]

6. Credentials and Compliance

The Staffing Agency shall provide personnel who hold current licenses, certifications, and registrations required for the assigned role, if applicable.

The following screening or compliance items shall be handled as follows:

☐ license verification
☐ background check
☐ skills checklist
☐ immunization or health records
☐ drug screening
☐ reference checks
☐ continuing education confirmation
☐ other: [Describe]

Additional compliance terms:

[Insert details]

7. Facility Policies and Patient Care Standards

Assigned personnel shall comply with applicable facility policies, safety procedures, reporting requirements, and professional standards while working at the Client’s site.

The Client is responsible for communicating site-specific rules, charting procedures, patient-care protocols, and other operational requirements relevant to the assignment.

Additional policy notes, if any:

[Insert details]

8. Term of Assignments

Assignments under this Contract may be:

☐ per diem
☐ temporary
☐ short-term contract
☐ long-term contract
☐ temp-to-hire
☐ other: [Describe]

Assignment start date or duration shall be determined in each staffing request or confirmation unless otherwise stated here:

[Insert details]

9. Rates and Fees

The Client shall pay the Staffing Agency as follows:

☐ hourly rate of [$Amount] per hour for [Role]
☐ shift rate of [$Amount] per shift for [Role]
☐ daily rate of [$Amount]
☐ weekend or holiday rate as follows: [Describe]
☐ overtime rate as follows: [Describe]
☐ on-call or callback rate as follows: [Describe]
☐ placement or conversion fee as follows: [Describe]
☐ other: [Describe]

Additional pricing details:

[Insert details]

10. Timekeeping and Approval

Hours worked shall be recorded and approved as follows:

☐ facility timesheet
☐ agency timesheet
☐ electronic timekeeping system
☐ scheduling platform record
☐ other: [Describe]

The Client shall review and approve or dispute time records within [Number] days after receipt.

If time records are not disputed within that period, they may be treated as accepted for billing purposes unless otherwise agreed in writing.

11. Invoicing and Payment

The Staffing Agency shall invoice the Client:

☐ weekly
☐ biweekly
☐ monthly
☐ after each assignment
☐ other: [Describe]

Invoices are due:

☐ upon receipt
☐ within [Number] days after invoice date
☐ according to the following schedule: [Describe]

Late payment terms, if any:

[Insert details]

12. Cancellation and Minimum Shift Terms

If the Client cancels a confirmed shift or assignment, the following terms apply:

☐ no cancellation fee
☐ cancellation fee if canceled within [Number] hours
☐ minimum billable hours of [Number]
☐ other: [Describe]

If the Staffing Agency cannot fill or maintain an assignment, it shall notify the Client as soon as reasonably possible and may provide a substitute if available.

13. Replacement and Removal of Personnel

If the Client reasonably determines that assigned personnel are not suitable for the assignment, the Client may request removal from the assignment.

The Staffing Agency shall handle replacement as follows:

[Insert replacement terms]

The Client may immediately remove assigned personnel from duty for urgent safety, conduct, or policy reasons, with prompt notice to the Staffing Agency.

14. Employment Status of Assigned Personnel

Personnel supplied by the Staffing Agency shall be considered:

☐ employees of the Staffing Agency
☐ independent contractors of the Staffing Agency
☐ other: [Describe]

Unless otherwise agreed in writing, assigned personnel are not employees of the Client solely because they perform services at the Client’s location.

Additional status terms, if any:

[Insert details]

15. Conversion or Direct Hire

If the Client hires or directly engages personnel introduced or assigned by the Staffing Agency, the following terms apply:

☐ no conversion fee
☐ conversion fee of [$Amount]
☐ conversion fee based on [Formula]
☐ conversion allowed after [Number] hours or days worked
☐ other: [Describe]

16. Confidentiality and Protected Information

Each party may receive confidential information relating to business operations, staffing, pricing, patients, records, or internal procedures.

Each party agrees to protect confidential information and not disclose or misuse it except as needed to perform this Contract or as required by law.

If protected health information or regulated data is involved, the parties shall handle those obligations as follows:

[Insert details]

17. Insurance and Risk Allocation

The following insurance terms apply:

☐ Staffing Agency shall maintain general liability insurance
☐ Staffing Agency shall maintain professional liability or malpractice insurance, if applicable
☐ Staffing Agency shall maintain workers’ compensation coverage, if applicable
☐ Client shall maintain facility insurance as applicable
☐ other: [Describe]

Coverage details, if any:

[Insert details]

Each party is responsible for its own acts and omissions under this Contract, subject to applicable law and any insurance coverage in place.

18. Term and Termination

This Contract begins on [Start Date] and continues until [End Date], unless ended earlier under this Contract.

Either party may terminate this Contract:

☐ on [Number] days’ written notice
☐ immediately for material breach
☐ immediately for patient safety or compliance concerns
☐ after completion of current assignment obligations
☐ under the following additional terms: [Describe]

Termination does not affect payment obligations for services already performed or amounts otherwise due unless otherwise agreed in writing.

19. Governing Law

This Contract shall be governed by the laws of the state of [State].

20. Entire Agreement

This Contract contains the full understanding between the parties regarding the healthcare staffing services described above and replaces prior discussions on the same subject unless otherwise stated in writing.

21. Signatures

Client Facility Signature: __________________________
Name: [Full Name]
Title: [Title]
Date: [Date]

Staffing Agency Signature: __________________________
Name: [Full Name]
Title: [Title]
Date: [Date]