Common use of Client Satisfaction Clause in Contracts

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Confirmed 

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirmed ⬜

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Confirmed ⬜

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Confirmed 

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirmed  Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Confirmed ?

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Confirmed ⬜

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Confirmed ⬜ Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Financial Information‌

Client Satisfaction. To the best of your knowledge, have any Clients treated in your Facility under the AHS Agreement experienced any unplanned hospital admissions or emergency room visits? Yes No If yes, please provide a summary (including Client PHN and reason for admission) as per requirements in Schedule D Reporting Requirements Annual Reporting Template (Continued) Unplanned Hospital Admissions and/or Emergency Room visits Annual Reporting Template (Continued) Complication rates (including nosocomial infections and major surgical complications): Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type Change of Ownership or Control Confirm that there has not been any change of ownership or control of your Facility since this Agreement with AHS was originally signed? Confirmed ⬜ Please provide the following: Intra-operatively Postoperatively Procedure Type Procedure Type