Common Contracts

PARTICIPATION AGREEMENT

Agreement • March 28th, 2013

• Contract Type
  Agreement
• Filed
  March 28th, 2013

THIS AGREEMENT is entered into effective the day of , 20 , by and between (a) THE ANESTHESIA QUALITY INSTITUTE, an Illinois not-for-profit corporation with its principal place of business at 520 N. Northwest Highway, Park Ridge, IL 60068 (“AQI”); and (b) , a group of anesthesiologists or healthcare facility whose principal place of business is at (“Participant”).