Dimples Facility Referral Agreement

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This agreement is between Dimples Care Advisors and the senior living community listed below for the purpose of referring potential residents.

Facility Name

Facility Address

Contact Person

Phone / Email

Phone / Email (copy)

The facility agrees to pay Dimples Care Advisors a referral fee equal to

% of the resident's first month's rent

or $

for any resident referred by Dimples Care Advisors who successfully moves into the community.

Payment will be made within

days after the resident has moved in and the first month's rent has been paid.

Dimples Care Advisors operates as an independent contractor and is not an employee or agent of the facility.

Either party may terminate this agreement with written notice.

Facility Representative Signature:

Date

Dimples Care Advisors Representative

Date