FEE FOR SERVICE MEDICAL SERVICES AGREEMENT (no provision for subcontractors) Date: <<Name of Health Service Provider>> and <<Title>> <<Given Name>> <<Family Name>> MEDICAL SERVICES AGREEMENT NO <<MSA Number>>Medical Services Agreement • July 1st, 2021 • Western Australia
ANDMedical Services Agreement • November 4th, 2005 • Amerigroup Corp • Hospital & medical service plans • Florida
MEDICAL SERVICES AGREEMENTMedical Services Agreement • May 5th, 2020 • Washington
This Medical Services Agreement (this “Agreement”), dated effective as of ck Down Arrow and Select Effective Date (the “Effective Date”), is made between The University of Puget Sound (“Puget Sound”) and Click and Enter Contractor Full Legal Name, located or formed in Click and Enter U.S. City, State or Non-U.S. Country Name (“Contractor”). In consideration of the mutual promises contained in this Agreement, Puget Sound and Contractor agree as follows:
Addendum to Medical Services Agreement (Additional Health Technician Services)Medical Services Agreement • November 16th, 2015
THIS ADDENDUM is made and entered into as of , 2015, by and between Wright County, a political subdivision of the State of Minnesota, 3800 Braddock Ave NE, Buffalo, MN 55313 (hereinafter, the “County”) and MEnD Correctional Care, PLLC, 67 - 10th Avenue South, Waite Park, MN 53687, a company employing doctor(s) and nursing staff licensed to practice medicine under the laws of the State of Minnesota (hereinafter, the “Provider”).
EX-10.1 4 d281487dex101.htm MEDICAL SERVICES AGREEMENT Medical Services AgreementMedical Services Agreement • May 5th, 2020
This Medical Services Agreement (“Agreement”) is made and entered into on January 6th by and between ALBITAR ONCOLOGY CONSULTING, LLC, a Delaware limited liability corporation (“Medical Group”), with its mailing address at 27165 Kiavo Drive, Valley Center, CA 92082 and NEOGENOMICS LABORATORIES, INC., a Florida Corporation (“NeoGenomics”).
CaliforniaCare MEDICAL SERVICES AGREEMENT Professional Care IPA Medical Group, Inc.Medical Services Agreement • August 27th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine • California
• If PARTICIPATING MEDICAL GROUP selects the Section 8.03A Enrollment Protection level of ***, once PARTICIPATING MEDICAL GROUP reaches *** Members at the beginning of the calendar year PARTICIPATING MEDICAL GROUP will receive an additional payment of $ PMPM.
CALIFORNIACARE MEDICAL SERVICES AGREEMENTMedical Services Agreement • August 27th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine • California
AIM MEDICAL SERVICES AGREEMENTMedical Services Agreement • August 27th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine • California
CaliforniaCare MEDICAL SERVICES AGREEMENTMedical Services Agreement • August 27th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine • California
This AGREEMENT is effective on January 1, 1997 between BLUE CROSS OF CALIFORNIA and Affiliates (jointly and severally “BLUE CROSS”) and Gateway Medical Group (“PARTICIPATING MEDICAL GROUP”).
ATHLETIC TRAINING & MEDICAL SERVICES AGREEMENTMedical Services Agreement • June 4th, 2020 • Pennsylvania
is made and entered as of the 15 day of June, 2020 (“Effective Date”) between UPMC Sports Medicine, a division of UPMC Presbyterian Shadyside (“UPMCSM”), Regional Health System (“RHS”), RHS and UPMCSM collectively referred to herein as “UPMC”) and Wattsburg Area School District (the “School”), (the School, RHS and UPMCSM each sometimes referred to herein as a “Party” and collectively the “Parties”);
Medical Services AgreementMedical Services Agreement • December 2nd, 2019 • Neogenomics Inc • Services-testing laboratories
This Medical Services Agreement (the “Agreement”) is made and effective on the date of the last signatory to the MSA (the “Effective Date”) by and between Lawrence Weiss, M.D., Inc., a California professional corporation (the “Medical Group”), with its mailing address at XXXXX and NeoGenomics Laboratories, Inc., a Florida corporation (together with its affiliates, “NeoGenomics”), with its mailing address at 12701 Commonwealth Dr., Suite 9, Fort Myers, FL 33913. NeoGenomics and Medical Group are each hereunder referred to individually as a “Party” and together as the “Parties.”
BLUE CROSS SENIOR SECURE MEDICARE+CHOICE MEDICAL SERVICES AGREEMENT Professional Care IPA Medical Group, Inc. *** Confidential Information omitted and filed separately with the Securities and Exchange Commission. BLUE CROSS SENIOR SECURE MEDICAL...Medical Services Agreement • May 5th, 2020 • California
This AGREEMENT is effective on November 1, 1999, between BLUE CROSS OF CALIFORNIA and Affiliates (jointly and severally “BLUE CROSS”) and Professional Care IPA Medical Group, Inc. (“PARTICIPATING MEDICAL GROUP”).
Addendum to Medical Services Agreement (Additional Nursing Services)Medical Services Agreement • November 11th, 2014
THIS ADDENDUM is made and entered into as of , 2014, by and between Wright County, a political subdivision of the State of Minnesota, 3800 Braddock Ave NE, Buffalo, MN 55313 (hereinafter, the “County”) and MEnD Correctional Care, LLC, 67 - 10th Avenue South, Waite Park, MN 53687, a company employing doctor(s) and nursing staff licensed to practice medicine under the laws of the State of Minnesota (hereinafter, the “Provider”).
AMENDMENT CALIFORNIACARE MEDICAL SERVICES AGREEMENTMedical Services Agreement • May 28th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine
This Amendment to the CALIFORNIACARE Medical Services Agreement is entered into at Woodland Hills, Los Angeles County. California, as of August 1, 1997 between Blue Cross of California and its Affiliates (“BLUE CROSS”) and Prospect Medical Group (“PARTICIPATING MEDICAL GROUP”).
AMENDMENT BLUE CROSS OF CALIFORNIA MEDICAL SERVICES AGREEMENTMedical Services Agreement • May 27th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine
This Amendment to the Blue Cross Medical Services Agreement is entered into at Woodland Hills, Los Angeles County, California, as of November 1, 1999 between Blue Cross of California and its Affiliates (“BLUE CROSS”) and PROCARE IPA (“PARTICIPATING MEDICAL GROUP”).
Paid Medical Services AgreementMedical Services Agreement • June 19th, 2024
This Paid Medical Services Agreement is the standard agreement and deed of adherence that shall regulate and guide the relations between Medical Park Limited Liability Partnership existing under the State License No. 13020241 dated December 26, 2013, hereinafter referred to as the “Medical Center” and the Patient, legal representative acting in the interests of the Patient, hereinafter referred to as the “Patient” on the other part, collectively hereinafter referred to as the “Parties”.
THIRD AMENDMENT TO MEDICAL SERVICES AGREEMENTMedical Services Agreement • July 12th, 2022
This Third Amendment to Medical Services Agreement (“Third Amendment”) is effective as of July 18, 2022 (“Third Amendment Effective Date”), and is made by and between CareHere Management, PLLC, a Delaware limited liability company, having its principal place of business at 5500 Maryland Way, Suite 120, Brentwood, TN 37027 (“CareHere”) and City of Douglasville, Georgia “(Employer”). CareHere and Employer are each individually a “Party” and are collectively the “Parties.” Capitalized terms used herein that are not otherwise defined have the meanings assigned to them in the Agreement, as defined below.
AMENDMENT CALIFORNIACARE MEDICAL SERVICES AGREEMENT BETWEEN BLUE CROSS OF CALIFORNIA AND NORTHWEST ORANGE COUNTY MEDICAL GROUP, INC.Medical Services Agreement • May 28th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine
This Amendment to the CaliforniaCare Medical Services Agreement is entered into at Woodland Hills, Los Angeles County, California, effective as of January 1, 1998 between BLUE CROSS OF CALIFORNIA and Affiliates (“BLUE CROSS”) and Northwest Orange County Medical Group, Inc. (“PARTICIPATING MEDICAL GROUP”).
MEDICAL SERVICES AGREEMENT between the International Organization for Migration and [Name of the Service Provider]Medical Services Agreement • March 23rd, 2023
This Medical Services Agreement is entered into by the International Organization for Migration, a related organization of the United Nations, acting through its [insert office name, e.g., Mission in XXX], [Address of the Office], represented by [Name, Title of Director, CoM, HoO], hereinafter referred to as “IOM,” and [Name of the Other Party], [Address], represented by [Name, Title of the representative of the Other Party], hereinafter referred to as the “Service Provider.” IOM and the Service Provider are also referred to individually as a “Party” and collectively as the “Parties.”
Consent for Personal Data Processing and Transfer of Confidential Medical InformationMedical Services Agreement • August 21st, 2024
(hereafter, the “Student”), under the Paid Medical Services Agreement (hereafter, the “Agreement”) signed between National Research University Higher School of Economics (hereafter, “HSE University”) and Municipal Polyclinic No. 3 under Moscow City Healthcare Department (hereafter, the “Medical Institution”),
CaliforniaCare MEDICAL SERVICES AGREEMENTMedical Services Agreement • May 28th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine • California
• If PARTICIPATING MEDICAL GROUP selects the Section 8.03A Enrollment Protection level of EIGHT THOUSAND DOLLARS ($8,000.00), once PARTICIPATING MEDICAL GROUP reaches two thousand (2,000) Members at the beginning of the calendar year PARTICIPATING MEDICAL GROUP will receive an additional payment of $ 0.26 PMPM.
CaliforniaCare MEDICAL SERVICES AGREEMENTMedical Services Agreement • May 28th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine • California
ContractMedical Services Agreement • May 5th, 2020 • Oklahoma
EX-10.1 3 wellquest_s1a-ex1001.htm MANAGEMENT AND MEDICAL SERVICES AGREEMENT EXHIBIT 10.1 MANAGEMENT AND MEDICAL SERVICES AGREEMENT THIS MANAGEMENT AND MEDICAL SERVICES AGREEMENT, (the “Agreement”) is made and entered into on this 4th day of May, 2005 to take effect on the 1st day of September, 2005, by and between Northwest Arkansas Primary Care Physicians, P.A., an Arkansas professional association (the “Practice”) and WellQuest Medical & Wellness Centers of Northwest Arkansas, Inc. d/b/a WellQuest, an Arkansas corporation (“WellQuest”). BACKGROUND: WellQuest intends to operate centers (the “WellQuest Centers”) throughout northwestern Arkansas that provide one-stop primary healthcare and wellness services. WellQuest plans to establish the initial WellQuest Center in Bentonville, Arkansas. Each WellQuest Center will consist of a medical spa, a retail health and wellness shop, and related health and wellness services as WellQuest determines are necessary or desirable. Each WellQuest Ce
ContractMedical Services Agreement • May 18th, 2021
THIS MEDICAL SERVICES AGREEMENT [the “SERVICE AGREEMENT” or “SA”] SHALL CONTROL THE DUTIES, OBLIGATIONS AND RIGHTS OWED TO AND BY RELYMD MEDICAL SERVICES, LLC (“RMG”), BY AND TO YOU (AS THE “CUSTOMER”). YOU ACKNOWLEDGE YOUR ACCEPTANCE OF THE TERMS AND CONDITIONS CONTAINED WITHIN THIS SA: (i) BY EXECUTING A SALES ORDER FORM THAT REFERENCES THIS SA; or, (ii) BY USING, REQUESTING, FACILITATING AND/OR ACCEPTING ANY SERVICE FROM RMG. IF YOU ARE ENTERING INTO THIS SA ON BEHALF OF A COMPANY OR OTHER LEGAL ENTITY (ALSO A “CUSTOMER’), YOU REPRESENT THAT YOU HAVE THE AUTHORITY TO BIND SUCH ENTITY AND ITS AFFILIATES TO THE TERMS AND CONDITIONS CONTAINED WITHIN THIS SA, IN WHICH CASE THE TERMS "YOU" OR "YOUR" CONTAINED HEREIN SHALL REFER TO SUCH ENTITY AND ITS AFFILIATES. IF YOU DO NOT HAVE SUCH AUTHORITY, or IF YOU DO NOT AGREE WITH THE RIGHTS AND DUTIES OF THE PARTIES AS SPECIFIED WITHIN THIS SA, YOU MUST NOT, AND MAY NOT, USE THE SERVICES, RELYMD NETWORK OR RELYMD PLATFORM.
AMENDMENT NO. 2 TO THE MEDICAL SERVICES AGREEMENTMedical Services Agreement • April 12th, 2023
This Amendment No. 2 to Medical Service Agreement (“Amendment No. 2”) is effective as of May 1, 2023 (“Amendment No. 2 Effective Date”), and is made by and between Premise Health Employer Solutions, LLC, a Delaware limited liability company, successor in interest to CareHere, LLC, having its principal place of business at 5500 Maryland Way, Suite 120, Brentwood, TN 37027 (“Premise Health”) and The Wilson County Board of Education, a Tennessee public school system, having its principal place of business at 415 Harding Drive, Lebanon, TN 37087 (“Client”). Premise Health and Client are each individually a “Party” and are collectively the “Parties.” Capitalized terms used herein that are not otherwise defined have the meanings assigned to them in the Agreement, as defined below.
THIRD AMENDMENT TO THE MEDICAL SERVICES AGREEMENT BETWEENMedical Services Agreement • October 30th, 2020 • Tennessee
This Third Amendment is entered into as of November 1, 2020 (the “Third Amendment”) by and between CareHere Management, PLLC (“CareHere”) and the Raytown Quality Schools (“Employer”), collectively the “Parties”, and each, a “Party”.
Medical Services Agreement Steven L. Smith, MD, PAMedical Services Agreement • August 1st, 2020
This Medical Services Agreement is entered into effective , 20 , between Steven L. Smith, MD (“Physician”) and (“Patient”). The Physician conducts a general internal medicine practice at 6108 Oakbend Trail, Suite 100, Fort Worth, Texas, 76132. In exchange for certain fees paid by Patient, the Physician, through the Professional Association, agrees to provide patient with the services described in this Agreement on the terms and conditions set forth in said Agreement. Due to the unique nature of the retainer-based practice model, the Physician and Patient have entered into this Agreement in order to clarify the nature and understanding of the services provided.
Amendment To MEDICAL Services AgreementMedical Services Agreement • October 1st, 2019
This Amendment to the Medical Services Agreement (the “Amendment”), effective as of Click Down Arrow and Select Amendment Effective Date (“Amendment Effective Date”), amends that certain Medical Services Agreement, dated as of Click Down Arrow and Select Effective Date (as amended, the “Agreement”), between The University of Puget Sound (“Puget Sound”) and Click and Enter Contractor Full Legal Name (“Contractor”). Capitalized terms used herein but not otherwise defined have the meanings given to them in the Agreement.
MEDICAL SERVICES AGREEMENT NO [#] OF [#]Medical Services Agreement • July 14th, 2009 • Western Australia
the Minister for Health in his incorporated capacity as the WA Country Health Service under s7 of the Hospitals and Health Services Act 1927 (WA) with responsibility for the Hospital named in Item 4 of Schedule 1 ("Board")
MEDICAL SERVICES AGREEMENTMedical Services Agreement • September 3rd, 2020
RESPONSIBILITY FOR PAYMENT: Any remaining vaccine costs not covered by the students insurance are the responsibility of the student.
Medical Services AgreementMedical Services Agreement • April 16th, 2020
This Medical Services Agreement (“Agreement”) is made and entered into on April 15, 2020 by and between BUCKHEAD CONCIERGE INTERNAL MEDICINE LLC, DBA BUCKHEAD a Georgia limited liability corporation (“Medical Group”), with its mailing address at 91 W. Wieuca Road, Building A, Suite 1000 and XYZ Corp, a Georgia Corporation (“Corporation”).
AMENDMENT TO CALIFORNIACARE MEDICAL SERVICES AGREEMENT BETWEEN BLUE CROSS OF CALIFORNIA AND Professional Care IPAMedical Services Agreement • May 27th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine
MEDICAL SERVICES AGREEMENTMedical Services Agreement • January 9th, 2024
Thank you for choosing Kelson Physician Partners of Layton, Inc., dba Wee Care Pediatrics (“WCP”) as your child’s health care provider. Our goal is to build a successful provider-patient relationship with you and your child. Your understanding of our Medical Services Agreement (the “Agreement”) and your responsibility for payment for services rendered is important to our relationship. If you have any questions regarding this Agreement or your account, please contact us at (801) 773-8644.
AMENDMENT CALIFORNIACARE MEDICAL SERVICES AGREEMENTMedical Services Agreement • May 28th, 2004 • Prospect Medical Holdings Inc • Services-offices & clinics of doctors of medicine
This Amendment to the CaliforniaCare Medical Services Agreement is entered into at Woodland Hills, Los Angeles County, California, as of January 1, 2001 between Blue Cross of California and its Affiliates (“BLUE CROSS”) and Prospect Health Source Medical Group (“PARTICIPATING MEDICAL GROUP”).
MEDICAL SERVICES AGREEMENTMedical Services Agreement • August 3rd, 2024
MEDICAL CONSENT: I consent to any treatments or procedures which may be performed on an outpatient basis (including emergency treatment or services), which may include but are not limited to medications, injections, taking of medical photographs, laboratory procedures, and/or x-ray examinations provided to me under the general and special instructions of the physicians, staff, or other health care providers of Kind Medical Group assisting my care.
