Common use of No Requirement to Refer Clause in Contracts

No Requirement to Refer. Nothing in this Agreement requires or obligates School to admit or cause the admittance of a patient to Hospital or to use Hospital’s services. None of the benefits granted pursuant to this Agreement is conditioned on any requirement or expectation that the parties make referrals to, be in a position to make or influence referrals to, or otherwise generate business for the other party. Neither party is restricted from referring any services to, or otherwise generating any business for, any other entity of their choosing. THE PARTIES HERETO have executed this Agreement as of the day and year first above written. The School Board of Sarasota County, Florida, through its Sarasota County Technical Institute By: Xxxx Xxxxxxx Title: Chair Approved for Legal Content, December 10, 2013 by Xxxxxxxx Eastmoore, Attorneys for The School Board of Sarasota County, Florida Signed: ASH Doctors Hospital of Sarasota [Hospital] By: Xxxxxx X. Xxxxx Title: President/CEO EXHIBIT A STATEMENT OF RESPONSIBILITY For and in consideration of the benefit provided the undersigned in the form of experience in a clinical setting at ("Hospital"), the undersigned and his/her heirs, successors and/or assigns do hereby covenant and agree to assume all risks and be solely responsible for any injury or loss sustained by the undersigned while participating in the Program operated by ("School") at Hospital unless such injury or loss arises solely out of Hospital's gross negligence or willful misconduct. Signature of Program Participant/Print Name Date Parent or Legal Guardian if Program Participant is under 18/Print Name Date Exhibit B Confidentiality and Security Agreement I understand that the facility or business entity (the “Company”) for which I work, volunteer or provide services manages health information as part of its mission to treat patients. Further, I understand that the Company has a legal and ethical responsibility to safeguard the privacy of all patients and to protect the confidentiality of their patients’ health information. Additionally, the Company must assure the confidentiality of its human resources, payroll, fiscal, research, internal reporting, strategic planning information, or any information that contains Social Security numbers, health insurance claim numbers, passwords, PINs, encryption keys, credit card or other financial account numbers (collectively, with patient identifiable health information, “Confidential Information”). In the course of my employment/assignment at the Company, I understand that I may come into the possession of this type of Confidential Information. I will access and use this information only when it is necessary to perform my job related duties in accordance with the Company’s Privacy and Security Policies, which are available on the Company intranet (on the Security Page) and the Internet (under Ethics & Compliance). I further understand that I must sign and comply with this Agreement in order to obtain authorization for access to Confidential Information or Company systems. General Rules

No Requirement to Refer. Nothing in this Agreement requires or obligates School to admit or cause the admittance of a patient to Hospital or to use Hospital’s services. None of the benefits granted pursuant to this Agreement is conditioned on any requirement or expectation that the parties make referrals to, be in a position to make or influence referrals to, or otherwise generate business for the other party. Neither party is restricted from referring any services to, or otherwise generating any business for, any other entity of their choosing. THE PARTIES HERETO have executed this Agreement as of the day and year first above written. Doctors Hospital of Sarasota [Hospital] By: Xxxxxx Xxxxx Title: President/CEO Date The School Board of Sarasota County, Florida, through Through its Sarasota County Technical Institute By: Xxxx Xxxxxxx Xxxxxxxx X. Xxxxxx, Title: Chair Date: Approved for Legal ContentContent January 26, December 102012, 2013 by Xxxxxxxx Matthews, Eastmoore, Hardy, Crauwels & Xxxxxx, Attorneys for The School Board of Sarasota County, Florida Signed: ASH Doctors Hospital of Sarasota [Hospital] By: Xxxxxx X. Xxxxx Title: President/CEO ASH_ EXHIBIT A STATEMENT OF RESPONSIBILITY For and in consideration of the benefit provided the undersigned in the form of experience in a clinical setting at ("Hospital"), the undersigned and his/her heirs, successors and/or assigns do hereby covenant and agree to assume all risks and be solely responsible for any injury or loss sustained by the undersigned while participating in the Program operated by ("School") at Hospital unless such injury or loss arises solely out of Hospital's gross negligence or willful misconduct. Signature of Program Participant/Print Name Date Parent or Legal Guardian if Program Participant is under 18/Print Name Date Exhibit EXHIBIT B Confidentiality PROTECTED HEALTH INFORMATION, CONFIDENTIALITY, AND SECURITY AGREEMENT  Protected Health Information (PHI) includes patient information based on examination, test results, diagnoses, response to treatment, observation, or conversation with the patient. This information is protected and Security Agreement I understand that the facility or business entity (the “Company”) for which I work, volunteer or provide services manages health information as part of its mission to treat patients. Further, I understand that the Company patient has a legal and ethical responsibility right to safeguard the privacy of all patients and to protect the confidentiality of their patients’ his or her patient care information whether this information is in written, electronic, or verbal format. PHI is individually-identifiable information that includes, but is not limited to, patient’s name, account number, birthdate, admission and discharge dates, photographs, and health plan beneficiary number.  Medical records, case histories, medical reports, images, raw test results, and medical dictations from healthcare facilities are used for student learning activities. Although patient identification is removed, all healthcare information must be protected and treated as confidential.  Students enrolled in school programs or courses and responsible faculty are given access to patient information. Additionally, the Company must assure the confidentiality of its human resources, payroll, fiscal, research, internal reporting, strategic planning information, or any information that contains Social Security numbers, health insurance claim numbers, passwords, PINs, encryption keys, credit card or other financial account numbers Students are exposed to PHI during their clinical rotations in healthcare facilities.  Students and responsible faculty may be issued computer identifications (collectively, with patient identifiable health information, “Confidential Information”). In the course of my employment/assignment at the Company, I understand that I may come into the possession of this type of Confidential Information. I will access and use this information only when it is necessary to perform my job related duties in accordance with the Company’s Privacy and Security Policies, which are available on the Company intranet (on the Security PageIDs) and the Internet (under Ethics & Compliance). I further understand that I must sign and comply with this Agreement in order passwords to obtain authorization for access to Confidential Information or Company systems. General RulesPHI.

No Requirement to Refer. Nothing in this Agreement requires or obligates School to admit or cause the admittance of a patient to Hospital or to use Hospital’s services. None of the benefits granted pursuant to this Agreement is conditioned on any requirement or expectation that the parties make referrals to, be in a position to make or influence referrals to, or otherwise generate business for the other party. Neither party is restricted from referring any services to, or otherwise generating any business for, any other entity of their choosing. THE PARTIES HERETO have executed this Agreement as of the day and year first above written. The School Board of Sarasota County, Florida, through its Sarasota County Technical Institute THE SCHOOL BOARD OF SARASOTA COUNTY By: Xxxx Xxxxxxx Title: Chair Approved for Legal ContentContent October 14, December 102009, 2013 by Xxxxxxxx Matthews, Eastmoore, Hardy, Crauwels & Xxxxxx, Attorneys for The School Board of Sarasota County, Florida Signed: ASH Doctors Hospital of Sarasota [Hospital] ASH_ XXXXXXX MEMORIAL HOSPITAL By: Xxxxxx X. Xxxxx Title: President/CEO EXHIBIT A STATEMENT OF RESPONSIBILITY For and in consideration of the benefit provided the undersigned in the form of experience in a clinical setting at ("Hospital"), the undersigned and his/her heirs, successors and/or assigns do hereby covenant and agree to assume all risks and be solely responsible for any injury or loss sustained by the undersigned while participating in the Program operated by ("School") at Hospital unless such injury or loss arises solely out of Hospital's gross negligence or willful misconduct. Signature of Program Participant/Print Name Date Parent or Legal Guardian if Program Participant is under 18/Print Name Date Exhibit EXHIBIT B Confidentiality PROTECTED HEALTH INFORMATION, CONFIDENTIALITY, AND SECURITY AGREEMENT  Protected Health Information (PHI) includes patient information based on examination, test results, diagnoses, response to treatment, observation, or conversation with the patient. This information is protected and Security Agreement I understand that the facility or business entity (the “Company”) for which I work, volunteer or provide services manages health information as part of its mission to treat patients. Further, I understand that the Company patient has a legal and ethical responsibility right to safeguard the privacy of all patients and to protect the confidentiality of their patients’ his or her patient care information whether this information is in written, electronic, or verbal format. PHI is individually-identifiable information that includes, but is not limited to, patient’s name, account number, birthdate, admission and discharge dates, photographs, and health plan beneficiary number.  Medical records, case histories, medical reports, images, raw test results, and medical dictations from healthcare facilities are used for student learning activities. Although patient identification is removed, all healthcare information must be protected and treated as confidential.  Students enrolled in school programs or courses and responsible faculty are given access to patient information. Additionally, the Company must assure the confidentiality of its human resources, payroll, fiscal, research, internal reporting, strategic planning information, or any information that contains Social Security numbers, health insurance claim numbers, passwords, PINs, encryption keys, credit card or other financial account numbers Students are exposed to PHI during their clinical rotations in healthcare facilities.  Students and responsible faculty may be issued computer identifications (collectively, with patient identifiable health information, “Confidential Information”). In the course of my employment/assignment at the Company, I understand that I may come into the possession of this type of Confidential Information. I will access and use this information only when it is necessary to perform my job related duties in accordance with the Company’s Privacy and Security Policies, which are available on the Company intranet (on the Security PageIDs) and the Internet (under Ethics & Compliance). I further understand that I must sign and comply with this Agreement in order passwords to obtain authorization for access to Confidential Information or Company systems. General RulesPHI.

No Requirement to Refer. Nothing in this Agreement requires or obligates School to admit or cause the admittance of a patient to Hospital or to use Hospital’s services. None of the benefits granted pursuant to this Agreement is conditioned on any requirement or expectation that the parties make referrals to, be in a position to make or influence referrals to, or otherwise generate business for the other party. Neither party is restricted from referring any services to, or otherwise generating any business for, any other entity of their choosing. THE PARTIES HERETO have executed this Agreement as of the day and year first above written. The San Antonio Independent School Board of Sarasota County, Florida, through its Sarasota County Technical Institute District By: Xxxx Xxxxxxx Xx. Xxxxx Xxxxxx Signature: Title: Chair Approved for Legal ContentSuperintendent Date: Methodist Healthcare System of San Antonio, December 10LTD, 2013 by Xxxxxxxx Eastmoore, Attorneys for The School Board of Sarasota County, Florida Signed: ASH Doctors Hospital of Sarasota [Hospital] LLP By: Xxxxxx X. Xxxxx Signature: Title: President/CEO EXHIBIT Date: Exhibit A STATEMENT OF RESPONSIBILITY For and in consideration of the benefit provided the undersigned in the form of experience in a clinical setting at ("Hospital"), the undersigned and his/her heirs, successors and/or assigns do hereby covenant and agree to assume all risks and be solely responsible for any injury or loss sustained by the undersigned while participating in the Program operated by by: ("School") at Hospital unless such injury or loss arises solely out of Hospital's gross negligence or willful misconduct. Signature of Program Participant/Print Name Date Parent or Legal Guardian if Date If Program Participant is under 18/18 / Print Name Date Submit this form to: XXXXxxxxxxXxxxxxxx@XXXXxxxxx.xxx Revised 03/2021 Exhibit B PLACEMENT AND COMPUTER ACCESS REQUEST FORM Name: Last First MI Status: Graduate student Undergraduate student Faculty RN Refresher School: Rotation Dates: From: to Home Address: (including city & zip code) Personal Phone Number: Personal Email Address: Date of Birth: (Must be accompanied by Confidentiality and & Security Agreement for non-employees) Are you a current MHS employee? Y N Current 3/4 ID Is Computer Access Required? Y N Facility for Rotation/Practicum: Methodist Hospital MSTH Metropolitan Northeast Boerne ED Texsan MASH-NW MASC-Med Center Stone Oak Methodist Hospital South Employees Only: I understand that employees who are students must use a secondary student role ID issued by the facility or business entity (Clinical & Professional Education Department for all activities and documentation associated with the “Company”) for which student role. Legally I work, volunteer or provide services manages health information as part of its mission to treat patientsam prohibited from using my employee ID when in my student role. Further, I understand that the Company has Flu vaccine must be obtained if you are doing a legal clinical day between November 1st and ethical responsibility to safeguard the privacy of all patients and to protect the confidentiality of their patients’ health information. Additionally, the Company must assure the confidentiality of its human resources, payroll, fiscal, research, internal reporting, strategic planning information, or any information that contains Social Security numbers, health insurance claim numbers, passwords, PINs, encryption keys, credit card or other financial account numbers (collectively, with patient identifiable health information, “Confidential Information”). In the course of my employment/assignment at the Company, I understand that I may come into the possession of this type of Confidential InformationMarch 30th. I received a Flu Vaccination on or signed a declination on and will access provide proof of such if requested. • I have a Photo Student ID to wear during my clinical rotation at MHS Yes No • I have read the Hospital Student Orientation Manual Yes No N/A I am an employee • Code of Conduct video: xxxxx://xxx-xxxxxxxxxxxxx.xxx/orientation/index.html All Graduate Students: I have watched the MHS Code of Conduct Video Yes No Preceptor Verification for Graduate Students and use First Assists: Signature 3/4 ID Date: Printed Name and Title Institution/Office Phone Number & Email Submit this information only when it completed form to: XXXXxxxxxxXxxxxxxx@xxxxxxxxx.xxx Revised 03/2021 Student Signature: Date: _ Exhibit C STUDENT VERIFICATION OF GOOD STANDING Applicant Preferred phone # Full Legal Name E-mail Institution: Contact person: Phone # E-mail I request # hours of clinical/Educational placement to begin on the day of , 20 . Anticipated end date of rotation day of , 20 . Requested Hospital/Unit/Department MHS PRECEPTOR VERIFICATION I, agree to precept for hours as requested above. Preceptor Signature Date Preceptor Printed Name Preceptor Phone # Preceptor’s Organization or Facility INSTITUTION VERIFICATION is necessary currently in good standing and is covered by blanket liability. The following documents are up to perform my job related duties in accordance with the Company’s Privacy date and Security Policies, which are available on the Company intranet upon request: (on the Check all that apply): 🞎 Federal criminal background clearance 🞎 Immunizations and TB 🞎 Flu vaccine or declination (applicable between November 1 – March 31) 🞎 BLS - Expiration date Institution Liaison Signature Date Institution Liaison Printed Name and Title Applicant Signature Date Printed Name Revised 03/2021 Submit this form to: XXXXxxxxxxXxxxxxxx@XXXXxxxxx.xxx Revised 03/2021 Exhibit D Workforce Member Confidentiality & Security Page) and the Internet Agreement (under Ethics & ComplianceCSA). I further understand that I must sign and comply with this Agreement in order to obtain authorization for access to Confidential Information or Company systems. General Rules

No Requirement to Refer. Nothing in this Agreement requires or obligates School district to admit or cause the admittance of a patient to Hospital or to use Hospital’s services. None of the benefits granted pursuant to this Agreement is conditioned on any requirement or expectation that the parties make referrals to, be in a position to make or influence referrals to, or otherwise generate business for the other party. Neither party is restricted from referring any services to, or otherwise generating any business for, any other entity of their choosing. THE PARTIES HERETO have executed this Agreement as of the day and year first above written. The (School Board District of Sarasota Clay County, Florida, through its Sarasota County Technical Institute ) By: Xxxx Xxxxxxx TitleXxxxx Xxxxxxxx attested: Chair Approved for Legal Content, December 10, 2013 by Xxxxxxxx Eastmoore, Attorneys for The School Board of Sarasota County, Florida Signed: ASH Doctors Hospital of Sarasota [Hospital] By: Xxxxxx Xxxxx X. Xxxxx Title: President/Chairman School Board Title: Superintendent of Schools Orange Park Medical Center By: Xxxxxxx Xxxx Title: CEO EXHIBIT A STATEMENT OF RESPONSIBILITY For and in consideration of the benefit provided the undersigned in the form of experience in a clinical setting at Orange Park Medical Center ("Hospital"), the undersigned and his/her heirs, successors and/or assigns do hereby covenant and agree to assume all risks and be solely responsible for any injury or loss sustained by the undersigned while participating in the Program operated by ("School"School District of Clay County) at Hospital unless such injury or loss arises solely out of Hospital's gross negligence or willful misconduct. Signature of Program Participant/Print Name Date Parent or Legal Guardian if Program Participant is under 18/Print Name Date Exhibit EXHIBIT B Confidentiality PROTECTED HEALTH INFORMATION, CONFIDENTIALITY, AND SECURITY AGREEMENT • Protected Health Information (PHI) includes patient information based on examination, test results, diagnoses, response to treatment, observation, or conversation with the patient. This information is protected and Security Agreement I understand that the facility or business entity (the “Company”) for which I work, volunteer or provide services manages health information as part of its mission to treat patients. Further, I understand that the Company patient has a legal and ethical responsibility right to safeguard the privacy of all patients and to protect the confidentiality of their patients’ his or her patient care information whether this information is in written, electronic, or verbal format. PHI is individually-identifiable information that includes, but is not limited to, patient’s name, account number, birthdate, admission and discharge dates, photographs, and health plan beneficiary number. • Medical records, case histories, medical reports, images, raw test results, and medical dictations from healthcare facilities are used for student learning activities. Although patient identification is removed, all healthcare information must be protected and treated as confidential. • Students enrolled in school programs or courses and responsible faculty are given access to patient information. Additionally, the Company must assure the confidentiality of its human resources, payroll, fiscal, research, internal reporting, strategic planning information, or any information that contains Social Security numbers, health insurance claim numbers, passwords, PINs, encryption keys, credit card or other financial account numbers Students are exposed to PHI during their clinical rotations in healthcare facilities. • Students and responsible faculty may be issued computer identifications (collectively, with patient identifiable health information, “Confidential Information”). In the course of my employment/assignment at the Company, I understand that I may come into the possession of this type of Confidential Information. I will access and use this information only when it is necessary to perform my job related duties in accordance with the Company’s Privacy and Security Policies, which are available on the Company intranet (on the Security PageIDs) and the Internet (under Ethics & Compliance). I further understand that I must sign and comply with this Agreement in order passwords to obtain authorization for access to Confidential Information or Company systems. General RulesPHI.

No Requirement to Refer. Nothing in this Agreement requires or obligates School to admit or cause the admittance of a patient to Hospital or to use Hospital’s services. None of the benefits granted pursuant to this Agreement is conditioned on any requirement or expectation that the parties make referrals to, be in a position to make or influence referrals to, or otherwise generate business for the other party. Neither party is restricted from referring any services to, or otherwise generating any business for, any other entity of their choosing. THE PARTIES HERETO have executed this Agreement as of the day and year first above written. The School Board of Sarasota County, Florida, through its Sarasota County Technical Institute Florida [Name of School] By: Xxxx Xxxxxxx Title: Chair Approved for Legal Content, December 10February 25, 2013 2015, by Xxxxxxxx EastmooreXxxxxxxxx, Attorneys for The School Board of Sarasota County, Florida Signed: ASH Doctors ASH_ Englewood Community Hospital of Sarasota [Hospital] By: Xxxxxx X. Xxxxx Title: President/CEO EXHIBIT A STATEMENT OF RESPONSIBILITY For and in consideration of the benefit provided the undersigned in the form of experience in a clinical setting at Englewood Community Hospital ("Hospital"), the undersigned and his/her heirs, successors and/or assigns do hereby covenant and agree to assume all risks and be solely responsible for any injury or loss sustained by the undersigned while participating in the Program operated by The School Board of Sarasota County, Florida ("School") at Hospital unless such injury or loss arises solely out of Hospital's gross negligence or willful misconduct. Signature of Program Participant/Print Name Date Parent or Legal Guardian if Program Participant is under 18/Print Name Date Exhibit B Confidentiality and Security Agreement I understand that the facility or business entity (the “Company”) for which I work, volunteer or provide services manages health information as part of its mission to treat patients. Further, I understand that the Company has a legal and ethical responsibility to safeguard the privacy of all patients and to protect the confidentiality of their patients’ health information. Additionally, the Company must assure the confidentiality of its human resources, payroll, fiscal, research, internal reporting, strategic planning information, or any information that contains Social Security numbers, health insurance claim numbers, passwords, PINs, encryption keys, credit card or other financial account numbers (collectively, with patient identifiable health information, “Confidential Information”). In the course of my employment/assignment at the Company, I understand that I may come into the possession of this type of Confidential Information. I will access and use this information only when it is necessary to perform my job related duties in accordance with the Company’s Privacy and Security Policies, which are available on the Company intranet (on the Security Page) and the Internet (under Ethics & Compliance). I further understand that I must sign and comply with this Agreement in order to obtain authorization for access to Confidential Information or Company systems. General Rules